Individual provider Active NPI

Lia Humphrey, LICSW

  • Clinical Social Worker
  • Manchester Center, VT
National Provider Identifier
1932430873
Registry record updated Nov 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
0890061719 Issued in VT
Practice address
82 Elm
Manchester Center, VT 05255-9370
Phone
(802) 367-1068
Fax
(802) 367-1069
NPI assigned
Jan 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 19, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 0890061719 VT Primary

Addresses

Primary practice location

82 Elm
Manchester Center, VT 05255-9370

Mailing address

82-Elm
Manchester Center, VT 05255-9370
Phone (508) 364-4331

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150901000364 MA Practitioner - Clinical Social Worker 3779772124 Practice locations: Nantucket, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

124 Surfside Rd
Nantucket, MA 02554-2884
Phone (508) 364-4331

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Lesley Brodie, M.D., P.C. Past Accepting new patients
Matrix Health Systems P.C. Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1263513600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1416355200000",
    "number": "1932430873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "82-ELM",
            "city": "MANCHESTER CENTER",
            "state": "VT",
            "postal_code": "052559370",
            "telephone_number": "508-364-4331",
            "fax_number": "802-367-1069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "82 ELM",
            "city": "MANCHESTER CENTER",
            "state": "VT",
            "postal_code": "052559370",
            "telephone_number": "802-367-1068",
            "fax_number": "802-367-1069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUMPHREY",
        "first_name": "LIA",
        "name_prefix": "Ms.",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-15",
        "last_updated": "2014-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "VT",
            "license": "0890061719",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Manchester Center, VT

Sources for this page

Verify at the official NPI Registry.