Life Span Development Center

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

Q1-0000548 Issued in DE

Legal business name

LIFE SPAN DEVELOPMENT CENTER

Practice address

260 Chapman Rd
Suite 200-1
Newark, DE 19702-5490

Phone

(302) 399-5773

Fax

(302) 832-9795

NPI assigned

Oct 12, 2016

Last updated

Jun 22, 2017By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Lamonte G Wilson, LCSWNPI 1649257346

Title

Owner/Clinician

Phone

(302) 399-5773

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Lamonte Garnett Wilson, MSW

  • Clinical Social Worker
  • Newark, DE
  • NPI 1649257346
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1476230400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1498089600000",
    "number": "1902356025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "260 CHAPMAN RD",
            "address_2": "SUITE 200-1",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025490",
            "telephone_number": "302-399-5773",
            "fax_number": "302-832-9795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "260 CHAPMAN RD",
            "address_2": "SUITE 200-1",
            "city": "NEWARK",
            "state": "DE",
            "postal_code": "197025490",
            "telephone_number": "302-399-5773",
            "fax_number": "302-832-9795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIFE SPAN DEVELOPMENT CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-12",
        "last_updated": "2017-06-22",
        "status": "A",
        "authorized_official_last_name": "WILSON",
        "authorized_official_first_name": "LAMONTE",
        "authorized_official_middle_name": "G",
        "authorized_official_title_or_position": "OWNER/CLINICIAN",
        "authorized_official_telephone_number": "302-399-5773",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "DE",
            "license": "Q1-0000548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Rochelle Liberato
• Paulette Liberi
• Douglas Lienesch, MD
• Eric Lieu
• Life at St. Francis Healthcare, Inc. (Saint Francis LIFE College Avenue)
• Nicholas Ligato, D.O.
• Barbara Light, DO
• Tamara F Lighty
• Deacon Lile, MD
• Sydney Liles, DPT

• Clinical Social Worker in Newark, DE
• Providers in Newark, DE by specialty
• Clinical Social Worker in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.