Individual provider Active NPI

Lisa Diane Pate, LCSW

  • Clinical Social Worker
  • Leland, NC
National Provider Identifier
1780907931
Registry record updated Jan 20, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
C014806 Issued in NC
Practice address
3847 Northern Lights Dr
Leland, NC 28451-0710
Phone
(607) 279-7728
NPI assigned
Mar 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 20, 2025

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 077074 NY
Clinical Social Worker 1041C0700X C014806 NC Primary

Addresses

Primary practice location

3847 Northern Lights Dr
Leland, NC 28451-0710

Mailing address

3847 Northern Lights Dr
Leland, NC 28451-0710
Phone (607) 279-7728

Other practice location 1

2512 Independence Blvd Ste 100
Wilmington, NC 28412-0019
Phone (910) 335-2841

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY, NC2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20190502000748 NY Practitioner - Clinical Social Worker 6800020736 Reassigns benefits to 1 organization
I20230531002143 NC Practitioner - Clinical Social Worker 6800020736 Practice locations: Leland, NC; Wilmington, NC

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2003
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
Shakespeare and Muscente LCSW PLLCGroup PAC ID 3870834013, 4 clinicians

Practice addresses (Care Compare)

121 W Court St
Suite 101
Ithaca, NY 14850-4105

3847 Northern Lights Dr
Leland, NC 28451-0710
Phone (910) 335-2841

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
077074NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Shakespeare & Muscente LCSW, PLLC CurrentSince Mar 4, 2019 Accepting new patients
TST Boces Past Accepting new patients
Franziska Racker Centers Inc Past Accepting new patients

Locations

121 W Court St
Ste 101
Ithaca, NY 14850
Phone (607) 256-4422

Organizations & group practices 3

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": "1267488000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1780907931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3847 NORTHERN LIGHTS DR",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284510710",
            "telephone_number": "607-279-7728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3847 NORTHERN LIGHTS DR",
            "city": "LELAND",
            "state": "NC",
            "postal_code": "284510710",
            "telephone_number": "607-279-7728"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2512 Independence Blvd Ste 100",
            "address_purpose": "LOCATION",
            "city": "Wilmington",
            "state": "NC",
            "postal_code": "284120019",
            "country_code": "US",
            "telephone_number": "910-335-2841",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PATE",
        "first_name": "LISA",
        "middle_name": "DIANE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-03-02",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "077074",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C014806",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Leland, NC

Sources for this page

Verify at the official NPI Registry.