Active NPI
Lissette Lugo, MSW
- Clinical Social Worker
- Trujillo Alto, PR
National Provider Identifier
1881988574
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 10706
- Practice address
- 860 Carr 175 Apt 1011
Senderos del Rios
Trujillo Alto, PR 00976 - Phone
- (787) 380-2288
- NPI assigned
- May 31, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 10706 | PR | Primary |
Addresses
Primary practice location
860 Carr 175 Apt 1011
Senderos del Rios
Trujillo Alto, PR 00976
Mailing address
860 Carr. 175 Senderos del Rio Apto. 1011
San Juan, PR 00926-8244
Phone (787) 380-2288
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PR
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20120828000208 | PR | Practitioner - Clinical Social Worker | 6800043845 | Practice locations: San Juan, PR |
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10706 | PR | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1306800000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1635724800000",
"number": "1881988574",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "860 CARR. 175 SENDEROS DEL RIO APTO. 1011",
"city": "SAN JUAN",
"state": "PR",
"postal_code": "009268244",
"telephone_number": "787-380-2288"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 CARR 175 APT 1011",
"address_2": "SENDEROS DEL RIOS",
"city": "TRUJILLO ALTO",
"state": "PR",
"postal_code": "00976",
"telephone_number": "787-380-2288"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LUGO",
"first_name": "LISSETTE",
"name_prefix": "Mrs.",
"credential": "MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-05-31",
"last_updated": "2021-11-01",
"certification_date": "2021-10-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "PR",
"license": "10706",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Trujillo Alto, PR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.