Active NPI
Lisa Gibson, LMSW
- Social Worker
- Brooklyn, NY
National Provider Identifier
1699521450
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 068169
- Practice address
- 134 N 4TH St
Brooklyn, NY 11249-3296 - Phone
- (914) 640-0799
- NPI assigned
- Apr 24, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 068169 | NY | Primary |
Addresses
Primary practice location
134 N 4TH St
Brooklyn, NY 11249-3296
Mailing address
1413 Highway 17 S # 364
Surfside Beach, SC 29575-6040
Phone (914) 640-0799
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 068169 | NY | MD | Social Worker |
Interoperability endpoints
- lisa.gibson.p1@direct.valerahealth.nextgenshare.com
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1713916800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1761609600000",
"number": "1699521450",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1413 HIGHWAY 17 S # 364",
"city": "SURFSIDE BEACH",
"state": "SC",
"postal_code": "295756040",
"telephone_number": "914-640-0799"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "134 N 4TH ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112493296",
"telephone_number": "914-640-0799"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GIBSON",
"first_name": "LISA",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-04-24",
"last_updated": "2025-10-28",
"certification_date": "2025-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "068169",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.