Active NPI
Lisa Martinez Peacock, LCSW, LSCSW, LISW-CP
- Clinical Social Worker
- Overland Park, KS
National Provider Identifier
1710245006
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 4138
- Practice address
- 7716 W 65TH St
Overland Park, KS 66202-3830 - Phone
- (913) 522-9283
- Fax
- (913) 353-9351
- NPI assigned
- Apr 24, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4138 | KS | Primary |
| Clinical Social Worker | 1041C0700X | 20-3244643 | MO |
Addresses
Primary practice location
7716 W 65TH St
Overland Park, KS 66202-3830
Mailing address
5400 Johnson Dr
Suite 288
Mission, KS 66205-2911
Phone (913) 522-9283
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 |
|---|---|---|---|
| 4138 | KS | MD | Clinical Social Worker |
| 20-3244643 | MO | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1335225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643760000000",
"number": "1710245006",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5400 JOHNSON DR",
"address_2": "SUITE 288",
"city": "MISSION",
"state": "KS",
"postal_code": "662052911",
"telephone_number": "913-522-9283",
"fax_number": "913-353-9351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7716 W 65TH ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662023830",
"telephone_number": "913-522-9283",
"fax_number": "913-353-9351"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PEACOCK",
"first_name": "LISA",
"middle_name": "MARTINEZ",
"name_prefix": "Mrs.",
"credential": "LCSW, LSCSW, LISW-CP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-04-24",
"last_updated": "2022-02-02",
"certification_date": "2022-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "KS",
"license": "4138",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "20-3244643",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Overland Park, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.