Active NPI
Lisa Stacey
- Social Worker
- Englewood, NJ
National Provider Identifier
1891020517
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 071928-1
- Practice address
- 61 Grand Ave
Englewood, NJ 07631-3572 - Phone
- (201) 568-0239
- Fax
- (201) 568-9780
- NPI assigned
- Oct 14, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 071928-1 | NY | Primary |
| Clinical Social Worker | 1041C0700X | 44SC05182900 | NJ |
Addresses
Primary practice location
61 Grand Ave
Englewood, NJ 07631-3572
Mailing address
61 Grand Ave
Englewood, NJ 07631-3572
Phone (201) 568-0239
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 071928-1 | NY | MD | Social Worker |
| 44SC05182900 | NJ | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1255478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1491436800000",
"number": "1891020517",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "61 GRAND AVE",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076313572",
"telephone_number": "201-568-0239",
"fax_number": "201-568-9780"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "61 GRAND AVE",
"city": "ENGLEWOOD",
"state": "NJ",
"postal_code": "076313572",
"telephone_number": "201-568-0239",
"fax_number": "201-568-9780"
}
],
"practiceLocations": [],
"basic": {
"last_name": "STACEY",
"first_name": "LISA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-10-14",
"last_updated": "2017-04-06",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "071928-1",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC05182900",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Englewood, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 6, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.