Lisa Gammoh – Social Worker in Aberdeen, NJ

Key facts

NPI: 1902432941
Entity type: Individual (NPI type 1)
Primary specialty: Social Worker 104100000X
License: 44SL05185300 (NJ)
Practice address: 20 Cambridge Dr Ste E
Aberdeen, NJ 07747-2256
Phone: (513) 817-4143
NPI assigned: Mar 22, 2020
Sex: Female
Sole proprietor: Yes

Organizations & group practices 1

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.

Tracy E Hood Clinical Social Worker · Aberdeen, NJ · NPI 1518428580

NPD (past) SINGLE SPECIALTY

Medicare participation

Medicare fee-for-service enrollment: Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD): No

State licenses

License	State	Type	Specialty
44SL05185300	NJ	MD	Social Worker

Practice roles

Organization	Specialty	Status	New patients
Tracy E Hood	Single Specialty	Past since Mar 29, 2020	Accepting new patients

Specialties & licenses

Specialty (taxonomy)	Code	License	State	Primary
Social Worker Group: 193400000X SINGLE SPECIALTY GROUP	104100000X	44SL05185300	NJ	Yes

Addresses

Primary practice location

20 Cambridge Dr Ste E
Aberdeen, NJ 07747-2256

Mailing address

20 Cambridge Dr Ste E
Aberdeen, NJ 07747-2256
Phone (513) 817-4143

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Mar 22, 2020.

{
    "created_epoch": "1584835200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1584835200000",
    "number": "1902432941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 CAMBRIDGE DR STE E",
            "city": "ABERDEEN",
            "state": "NJ",
            "postal_code": "077472256",
            "telephone_number": "513-817-4143"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 CAMBRIDGE DR STE E",
            "city": "ABERDEEN",
            "state": "NJ",
            "postal_code": "077472256",
            "telephone_number": "513-817-4143"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAMMOH",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-03-22",
        "last_updated": "2020-03-22",
        "certification_date": "2020-03-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker",
            "state": "NJ",
            "license": "44SL05185300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Aberdeen, NJ

All providers in Aberdeen, NJ · Social Worker in New Jersey

Sources for this page

NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2020. Information in NPPES is self-reported and not verified by CMS.
NUCC Health Care Provider Taxonomy: specialty names.
National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.