Individual provider Active NPI

Lisa R Tobin, LCSW.-R

  • Clinical Social Worker
  • Niskayuna, NY
National Provider Identifier
1942769765
Registry record updated Sep 25, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
069521 Issued in NY
Practice address
2310 Nott Street East
Suite 3
Niskayuna, NY 12309
Phone
(518) 374-6263
Fax
(518) 289-5225
NPI assigned
Mar 19, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 25, 2023

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 069521 NY Primary

Addresses

Primary practice location

2310 Nott Street East
Suite 3
Niskayuna, NY 12309

Mailing address

5 Hemphill Place
Suite 121
Malta, NY 12020-4423
Phone (518) 289-5072

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20190620002830 NY Order and Referring Only - Clinical Social Worker 5890029169

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Union Street Counseling Services, LLC CurrentSince Oct 1, 2023 Accepting new patients
Union Counseling Services, PLLC Past Accepting new patients

Locations

5 Hemphill Pl
Ste 121
Malta, NY 12020
Phone (518) 289-5072

2310 Nott St E
Ste 3
Niskayuna, NY 12309
Phone (518) 374-6263

1311 Union St
Schenectady, NY 12308
Phone (518) 374-6263

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": "1552953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1695600000000",
    "number": "1942769765",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5 HEMPHILL PLACE",
            "address_2": "SUITE 121",
            "city": "MALTA",
            "state": "NY",
            "postal_code": "120204423",
            "telephone_number": "518-289-5072",
            "fax_number": "518-289-5225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 NOTT STREET EAST",
            "address_2": "SUITE 3",
            "city": "NISKAYUNA",
            "state": "NY",
            "postal_code": "12309",
            "telephone_number": "518-374-6263",
            "fax_number": "518-289-5225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOBIN",
        "first_name": "LISA",
        "middle_name": "R",
        "credential": "LCSW.-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-03-19",
        "last_updated": "2023-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069521",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Niskayuna, NY

Sources for this page

Verify at the official NPI Registry.