Individual provider Active NPI

Lisa A Levin, LCSW, CAS, CECP

  • Clinical Social Worker
  • South Bend, IN
National Provider Identifier
1760620090
Registry record updated Apr 27, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
34005742A Issued in IN
Practice address
62803 US 31 S
South Bend, IN 46614-4832
Phone
(574) 313-1374
NPI assigned
Jan 23, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 34005742A IN Primary
Clinical Social Worker 1041C0700X 097536-01 NY

Addresses

Primary practice location

62803 US 31 S
South Bend, IN 46614-4832

Mailing address

62803 US 31 S
South Bend, IN 46614-4832
Phone (574) 313-1374

Other practice location 1

415 E Madison St
South Bend, IN 46617-2322
Phone (574) 533-1234 ext. 4705

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20180912001496 IN Practitioner - Clinical Social Worker 6901043314 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Oaklawn Psychiatric Center IncGroup PAC ID 6002801065, 66 clinicians

Practice addresses (Care Compare)

330 Lakeview Dr
Goshen, IN 46528-9365
Phone (574) 533-1234

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
097536-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Oaklawn Psychiatric Center, Inc. CurrentSince Jul 7, 2018 Accepting new patients
Oaklawn Psychiatric Center, Inc. CurrentSince Jul 7, 2018 Accepting new patients

Locations

330 Lakeview Dr
Goshen, IN 46528
Phone (219) 533-1234

415 E Madison St
South Bend, IN 46617
Phone (574) 283-1234

Organizations & group practices 2

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": "1232668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777248000000",
    "number": "1760620090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "62803 US 31 S",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466144832",
            "telephone_number": "574-313-1374"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62803 US 31 S",
            "city": "SOUTH BEND",
            "state": "IN",
            "postal_code": "466144832",
            "telephone_number": "574-313-1374"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "415 E Madison St",
            "address_purpose": "LOCATION",
            "city": "South Bend",
            "state": "IN",
            "postal_code": "466172322",
            "country_code": "US",
            "telephone_number": "574-533-1234 x4705",
            "fax_number": "574-537-2652",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LEVIN",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW, CAS, CECP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-23",
        "last_updated": "2026-04-27",
        "certification_date": "2026-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IN",
            "license": "34005742A",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "097536-01",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Bend, IN

Sources for this page

Verify at the official NPI Registry.