Individual provider Active NPI

Lisa J Perkins, LICSW

  • Clinical Social Worker
  • Yarmouth Port, MA
National Provider Identifier
1790177830
Registry record updated Jan 1, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
411 Route 6a BLDG 5 Unit C
Yarmouth Port, MA 02675-1843
Phone
(774) 212-5715
Fax
(508) 433-1871
NPI assigned
Feb 26, 2015
Last updated
Jan 1, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 1, 2019

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 Primary

Addresses

Primary practice location

411 Route 6a BLDG 5 Unit C
Yarmouth Port, MA 02675-1843

Mailing address

5 Greeneedle LN
Dennis Port, MA 02639-1842
Phone (774) 212-5715

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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
I20190306001405 MA Practitioner - Clinical Social Worker 1355680554 Practice locations: Yarmouth Port, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

411 Route 6a
Unit C
Yarmouth Port, MA 02675-1843
Phone (774) 212-5715

411 Route 6a BLDG 5 Unit C
Yarmouth Port, MA 02675-1843

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lisa J Perkins Psychotherapy Clinical PastSince Dec 1, 2018 Accepting new patients

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1424908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546300800000",
    "number": "1790177830",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 GREENEEDLE LN",
            "city": "DENNIS PORT",
            "state": "MA",
            "postal_code": "026391842",
            "telephone_number": "774-212-5715",
            "fax_number": "508-433-1871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 ROUTE 6A BLDG 5 UNIT C",
            "city": "YARMOUTH PORT",
            "state": "MA",
            "postal_code": "026751843",
            "telephone_number": "774-212-5715",
            "fax_number": "508-433-1871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PERKINS",
        "first_name": "LISA",
        "middle_name": "J",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-02-26",
        "last_updated": "2019-01-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yarmouth Port, MA

Sources for this page

Verify at the official NPI Registry.