Lisa Marie Sergentanis, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

113028 Issued in MA

Practice address

143 Shaker Road
East Longmeadow, MA 01028-0216

Phone

(413) 525-1711

NPI assigned

Apr 30, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Nov 12, 2021 through Nov 12, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Therapeutic Connection, P.C.

  • Mental Health Counselor
  • East Longmeadow, MA
  • NPI 1336351584
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710107941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "143 SHAKER RD",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010282786",
            "telephone_number": "413-525-1711"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "143 SHAKER ROAD",
            "city": "EAST LONGMEADOW",
            "state": "MA",
            "postal_code": "010280216",
            "telephone_number": "413-525-1711"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SERGENTANIS",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "113028",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICSW",
            "identifier": "113028",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Ingrid Schweiger, ED.D.
• Megan Scranton, LMHC, NCC
• Megan Scutti
• Kyle Sears
• Kaeli Serafino
• Sheida Shahnazi
• Shaping Success LLC
• Anup Sharma
• Valerie C. Sharpe, M.D.
• Margaret Shea, RDO

• Clinical Social Worker in East Longmeadow, MA
• Providers in East Longmeadow, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.

Verify at the official NPI Registry.