Lisa Lucker Etkins, LCSW, OSW-C

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

CW016097 Issued in PA

Practice address

505 S 22ND St
Philadelphia, PA 19146-1246

Phone

(215) 545-1175

NPI assigned

Jan 17, 2009

Last updated

Dec 27, 2011By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1232150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324944000000",
    "number": "1861639510",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2401 PENNSYLVANIA AVE",
            "address_2": "7B22",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191303010",
            "telephone_number": "215-232-2848"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "505 S 22ND ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191461246",
            "telephone_number": "215-545-1175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETKINS",
        "first_name": "LISA",
        "middle_name": "LUCKER",
        "name_prefix": "Mrs.",
        "credential": "LCSW, OSW-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-01-17",
        "last_updated": "2011-12-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016097",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kambeze Banan Etemad, M.D.
• Ethel Lee Zachary Foundation
• Mark Etherington, MD
• Dominique Etienne, PA-C
• Olivia Ann Etienne, MD
• Abimbola Etou
• Beth Simone Etra, M.D.
• Jennifer B Ettenger
• Arielle Ettinger, LSW
• Jeffrey Batt Ettinger, MD

• Clinical Social Worker in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Clinical Social Worker in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 27, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.