Individual provider Active NPI

Lisette Pineda, LCSW

  • Clinical Social Worker
  • New Rochelle, NY
National Provider Identifier
1740316090
Registry record updated Oct 29, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
078322-1 Issued in NY
Practice address
110 Lockwood Ave
Ste 403
New Rochelle, NY 10801-5013
Phone
(914) 713-7901
Fax
(914) 350-5070
NPI assigned
Feb 23, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2021

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 078322-1 NY Primary

Addresses

Primary practice location

110 Lockwood Ave
Ste 403
New Rochelle, NY 10801-5013

Mailing address

607 Bronx River Rd
Yonkers, NY 10704-1703
Phone (914) 363-0433

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20121106000169 NY Practitioner - Clinical Social Worker 5294986998 Reassigns benefits to 1 organization
Practice locations: New Rochelle, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
078322NYMDSocial Worker
078322-1NYMDClinical Social Worker

Organizations & group practices 1

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": "1172188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1635465600000",
    "number": "1740316090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "607 BRONX RIVER RD",
            "city": "YONKERS",
            "state": "NY",
            "postal_code": "107041703",
            "telephone_number": "914-363-0433"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 LOCKWOOD AVE",
            "address_2": "STE 403",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108015013",
            "telephone_number": "914-713-7901",
            "fax_number": "914-350-5070"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PINEDA",
        "first_name": "LISETTE",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-23",
        "last_updated": "2021-10-29",
        "certification_date": "2021-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078322-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

Verify at the official NPI Registry.