Individual provider Active NPI

Liesa A Watson, LCSW

  • Clinical Social Worker
  • Jersey City, NJ
National Provider Identifier
1932857612
Registry record updated Mar 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC06060400 Issued in NJ
Practice address
213 York St
Jersey City, NJ 07302-3622
Phone
(917) 531-2361
NPI assigned
Mar 12, 2022
Last updated
Mar 12, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 12, 2022

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 44SC06060400 NJ Primary

Addresses

Primary practice location

213 York St
Jersey City, NJ 07302-3622

Mailing address

213 York St
Jersey City, NJ 07302-3622
Phone (917) 531-2361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in VI
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
I20230719004049 VI Practitioner - Clinical Social Worker 5294195483

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC06060400NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Frederiksted Health Care, Inc. Current Accepting new patients

Locations

516 Strand St
Frederiksted, VI 00840
Phone (340) 772-1992

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1647043200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1647043200000",
    "number": "1932857612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "213 YORK ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023622",
            "telephone_number": "917-531-2361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "213 YORK ST",
            "city": "JERSEY CITY",
            "state": "NJ",
            "postal_code": "073023622",
            "telephone_number": "917-531-2361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATSON",
        "first_name": "LIESA",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-12",
        "last_updated": "2022-03-12",
        "certification_date": "2022-03-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC06060400",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jersey City, NJ

Sources for this page

Verify at the official NPI Registry.