Individual provider Active NPI

Lisa Mary Annulis, LCSW-C

  • Clinical Social Worker
  • Rockville, MD
National Provider Identifier
1831389261
Registry record updated Aug 1, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
07914 Issued in MD
Practice address
932 Hungerford Dr
Rockville, MD 20850-1713
Phone
(301) 233-5721
Fax
(301) 231-6341
NPI assigned
Aug 1, 2007
Last updated
Aug 1, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 1, 2007

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 07914 MD Primary

Addresses

Primary practice location

932 Hungerford Dr
Rockville, MD 20850-1713

Mailing address

11813 Hitching Post LN
Rockville, MD 20852-4407
Phone (301) 233-5721

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
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
I20170524000355 DC Practitioner - Clinical Social Worker 6608195722 Practice locations: Rockville, MD

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1680 E Gude Dr
Suite 104
Rockville, MD 20850-5360
Phone (301) 233-5721

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
07914MDMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1185926400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1185926400000",
    "number": "1831389261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11813 HITCHING POST LN",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208524407",
            "telephone_number": "301-233-5721",
            "fax_number": "301-231-6341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "932 HUNGERFORD DR",
            "city": "ROCKVILLE",
            "state": "MD",
            "postal_code": "208501713",
            "telephone_number": "301-233-5721",
            "fax_number": "301-231-6341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANNULIS",
        "first_name": "LISA",
        "middle_name": "MARY",
        "credential": "LCSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-08-01",
        "last_updated": "2007-08-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "07914",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rockville, MD

Sources for this page

Verify at the official NPI Registry.