Lisa Anne Peaty, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

C004933 Issued in NC

Practice address

610 Coliseum Dr
Winston Salem, NC 27106-5325

Phone

(336) 722-8173

Fax

(336) 724-6491

NPI assigned

Aug 30, 2007

Last updated

Aug 30, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other names 1

• Ms. Lisa Anne Sinksen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 28, 2020 through May 28, 2028

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Peaty Counseling and Consulting, PLLC

  • Clinical Social Worker
  • Winston Salem, NC
  • NPI 1659900793
  NPD Authorized official
• Family Services, Inc.

  • Clinical Social Worker
  • Winston Salem, NC
  • NPI 1225108707
  NPD (past)

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

{
    "created_epoch": "1188432000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188432000000",
    "number": "1811181050",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 COLISEUM DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065325",
            "telephone_number": "336-722-8173",
            "fax_number": "336-724-6491"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 COLISEUM DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271065325",
            "telephone_number": "336-722-8173",
            "fax_number": "336-724-6491"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEATY",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-30",
        "last_updated": "2007-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "C004933",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "SINKSEN",
            "middle_name": "ANNE",
            "prefix": "MS.",
            "credential": "LCSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Luke Alexander Pearsall, PA
• Cydney Pearson, PMHNP-BC
• Mark Ray Pearson, M.D.
• Patrice S Pearson, NP
• Peaty Counseling and Consulting, PLLC
• Robert A. Peaty, LMFT
• Kenneth Alton Peavy, D.M.D.
• Julia Celeste Peay, MD, JD
• Pec LTC PA
• Robins Nicholas Peck, PHARMD

• Clinical Social Worker in Winston Salem, NC
• Providers in Winston Salem, NC by specialty
• Clinical Social Worker in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.