Individual provider Active NPI

Lisa Lawrence, LCSW

  • Clinical Social Worker
  • Granite City, IL
National Provider Identifier
1720606973
Registry record updated Jul 13, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
149.021852 Issued in IL
Practice address
2100 Madison Ave
Granite City, IL 62040-4713
Phone
(618) 798-3000
NPI assigned
Jul 13, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 149.021852 IL Primary

Addresses

Primary practice location

2100 Madison Ave
Granite City, IL 62040-4713

Mailing address

9316 N Humbert Rd
Brighton, IL 62012-2026
Phone (618) 623-1334

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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

Enrollment IDStateProvider typePAC IDDetails
I20200917001311 IL Practitioner - Clinical Social Worker 6103244520 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Osf Healthcare SystemGroup PAC ID 4284541806, 94 clinicians

Practice addresses (Care Compare)

1 Saint Anthonys Way
Alton, IL 62002-4568
Phone (618) 465-2571

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
149.021852ILMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Osf Healthcare System Clinical CurrentSince Feb 21, 2025 Accepting new patients
Osf Multi-Specialty Group CurrentSince Jul 15, 2025 Accepting new patients
Central PA Pharmacy LLC. Current Accepting new patients
Osf Healthcare System CurrentSince Feb 21, 2025 Accepting new patients

Locations

1 Saint Anthonys Way
Alton, IL 62002
Phone (618) 233-6870

124 SW Adams St
Peoria, IL 61602
Phone (309) 655-2850

8600 State Route 91
Ste 130
Peoria, IL 61615
Phone (309) 683-5050

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1594598400000",
    "number": "1720606973",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9316 N HUMBERT RD",
            "city": "BRIGHTON",
            "state": "IL",
            "postal_code": "620122026",
            "telephone_number": "618-623-1334"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 MADISON AVE",
            "city": "GRANITE CITY",
            "state": "IL",
            "postal_code": "620404713",
            "telephone_number": "618-798-3000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWRENCE",
        "first_name": "LISA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2020-07-13",
        "certification_date": "2020-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IL",
            "license": "149.021852",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Granite City, IL

Sources for this page

Verify at the official NPI Registry.