Lisa J Caravousanos, LCSWR

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

072684 Issued in NY

Practice address

550 Montauk Hwy
Shirley, NY 11967-2114

Phone

(631) 490-3040

Fax

(631) 490-3055

NPI assigned

May 25, 2007

Last updated

Jun 14, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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

• Brookhaven Memorial Hospital Medical Center, Inc.

  dba Brookhaven Memorial Hospital Palliative Care Dept.

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Patchogue, NY
  • NPI 1417232760
  Medicare reassignment NPD
• Sun River Health Inc

  • Federally Qualified Health Center (FQHC)
  • Amenia, NY
  • NPI 1568526838
  Medicare reassignment NPD
• Brookhaven Memorial Hospital Medical Center, Inc.

  dba Long Island Community Hospital

  • Emergency Medicine Physician
  • Patchogue, NY
  • NPI 1639121825
  NPD
• Long Island Community Hospital at NYU Langone Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Shirley, NY
  • NPI 1902029796
  NPD
• Sun River Health Inc

  • Adult Day Care Clinic/Center
  • Bronx, NY
  • NPI 1740763275
  NPD
• Sun River Health Inc.

  • Federally Qualified Health Center (FQHC)
  • Peekskill, NY
  • NPI 1619969458
  NPD

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

{
    "created_epoch": "1180051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1718323200000",
    "number": "1720299167",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5036",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106025036",
            "telephone_number": "845-745-3611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 MONTAUK HWY",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119672114",
            "telephone_number": "631-490-3040",
            "fax_number": "631-490-3055"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARAVOUSANOS",
        "first_name": "LISA",
        "middle_name": "J",
        "credential": "LCSWR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-25",
        "last_updated": "2024-06-14",
        "certification_date": "2024-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "072684",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "03090140",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Alexandra Elizabeth Calestini, LCSW
• McKenzie Callagy, LPN
• Leanna Campo
• Ashley Maria Canas
• Gina Caputo, LCSW
• Jordan Michelle Caro, PHARMD
• Samantha M Caropelo, CASAC-ADVANCED
• Lawrence Cassano, DPM
• John T Cassara, RPH
• Catana Physical Therapy PC

• Clinical Social Worker in Shirley, NY
• Providers in Shirley, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 14, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.