Individual provider Active NPI

Lisa Margaret Hartley, MSW, LCSW

  • Clinical Social Worker
  • Fairfield, CT
National Provider Identifier
1881882298
Registry record updated Mar 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
13713 Issued in CT
Practice address
55 Walls Dr Ste 206
Fairfield, CT 06824-5180
Phone
(203) 689-8989
NPI assigned
Oct 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 21, 2024

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 13713 CT Primary

Addresses

Primary practice location

55 Walls Dr Ste 206
Fairfield, CT 06824-5180

Mailing address

55 Walls Dr Ste 206
Fairfield, CT 06824-5180
Phone (203) 689-8989

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20240401003086 CT Practitioner - Clinical Social Worker 1456799113 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Behavioral Health Center for Counseling and Learning LLCGroup PAC ID 8729313135, 27 clinicians

Practice addresses (Care Compare)

984 Southford Rd
Middlebury, CT 06762-3234
Phone (203) 758-2400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
13713CTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Compassionate Care Counseling LLC CurrentSince Aug 19, 2024 Accepting new patients
Behavioral Health Center for Counseling & Learning, LLC CurrentSince Aug 19, 2024 Accepting new patients
Emh Family Services PC CurrentSince Apr 15, 2024 Accepting new patients

Locations

55 Walls Dr
Ste 206
Fairfield, CT 06824
Phone (203) 635-5776

984 Southford Rd
Middlebury, CT 06762
Phone (203) 758-2400

1000 Bridgeport Ave
Ste 202
Shelton, CT 06484
Phone (203) 712-9998

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": "1191974400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1881882298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 WALLS DR STE 206",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245180",
            "telephone_number": "203-689-8989"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 WALLS DR STE 206",
            "city": "FAIRFIELD",
            "state": "CT",
            "postal_code": "068245180",
            "telephone_number": "203-689-8989"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARTLEY",
        "first_name": "LISA",
        "middle_name": "MARGARET",
        "name_prefix": "Ms.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-10-10",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "13713",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fairfield, CT

Sources for this page

Verify at the official NPI Registry.