Active NPI
Lisa Levy Dale, L.C.S.W.
- Clinical Social Worker
- Roswell, GA
National Provider Identifier
1700061710
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- CSW003366
- Practice address
- 11755 Pointe PL
Suite a-1
Roswell, GA 30076-4636 - Phone
- (678) 570-8444
- NPI assigned
- Jan 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | CSW003366 | GA | Primary |
Addresses
Primary practice location
11755 Pointe PL
Suite a-1
Roswell, GA 30076-4636
Mailing address
336 Saint Claire Dr
Alpharetta, GA 30004-3399
Phone (678) 570-8444
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective May 28, 2024 through May 28, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CSW003366 | GA | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1199750400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1199750400000",
"number": "1700061710",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "336 SAINT CLAIRE DR",
"city": "ALPHARETTA",
"state": "GA",
"postal_code": "300043399",
"telephone_number": "678-570-8444"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11755 POINTE PL",
"address_2": "SUITE A-1",
"city": "ROSWELL",
"state": "GA",
"postal_code": "300764636",
"telephone_number": "678-570-8444"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DALE",
"first_name": "LISA",
"middle_name": "LEVY",
"name_prefix": "Ms.",
"credential": "L.C.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-01-08",
"last_updated": "2008-01-08",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "GA",
"license": "CSW003366",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Roswell, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.