Active NPI
Lisa A Randazzo, L.M.S.W.
- Social Worker
- Wantagh, NY
National Provider Identifier
1922451830
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 090315
- Practice address
- 3404 Lufberry Ave
Wantagh, NY 11793-3057 - Phone
- (516) 458-8116
- NPI assigned
- Jul 14, 2016
- 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 |
|---|---|---|---|---|
| Social Worker | 104100000X | 090315 | NY | Primary |
Addresses
Primary practice location
3404 Lufberry Ave
Wantagh, NY 11793-3057
Mailing address
3404 Lufberry Ave
Wantagh, NY 11793-3057
Phone (516) 458-8116
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 21, 2024 through Nov 21, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1468454400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1468454400000",
"number": "1922451830",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3404 LUFBERRY AVE",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117933057",
"telephone_number": "516-458-8116"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3404 LUFBERRY AVE",
"city": "WANTAGH",
"state": "NY",
"postal_code": "117933057",
"telephone_number": "516-458-8116"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RANDAZZO",
"first_name": "LISA",
"middle_name": "A",
"name_prefix": "Ms.",
"credential": "L.M.S.W.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-07-14",
"last_updated": "2016-07-14",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "090315",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wantagh, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 14, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.