Lisa McCordic, RNCS

Primary specialty

Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0808X

License

178205 Issued in MA

Practice address

151 Mystic Ave
Suite Six
Medford, MA 02155-4632

Phone

(781) 396-1199

Fax

(781) 396-1439

NPI assigned

Oct 31, 2007

Last updated

Oct 31, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Lisa Luczkow Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• DCS Mental Health, Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Medford, MA
  • NPI 1215912894
  NPD (past)

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

{
    "created_epoch": "1193788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193788800000",
    "number": "1962681460",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "151 MYSTIC AVE",
            "address_2": "SUITE SIX",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554632",
            "telephone_number": "781-396-1199",
            "fax_number": "781-396-1439"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "151 MYSTIC AVE",
            "address_2": "SUITE SIX",
            "city": "MEDFORD",
            "state": "MA",
            "postal_code": "021554632",
            "telephone_number": "781-396-1199",
            "fax_number": "781-396-1439"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCCORDIC",
        "first_name": "LISA",
        "credential": "RNCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-31",
        "last_updated": "2007-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0808X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health",
            "state": "MA",
            "license": "178205",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "PN0723",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LUCZKOW",
            "credential": "C.S",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Blair McCafferty, LCSW
• Mary Jane McCarron, MD
• Edward John McCarthy, LICSW
• Timothy Francis McCarthy, LMHC
• Greyson McConnell
• Elissa McDavid
• Victoria McDermott, NP
• Nancy McDonald
• Phylicia McDonald
• Tyler McEachron, LCSW

• Psychiatric/Mental Health Registered Nurse in Medford, MA
• Providers in Medford, MA by specialty
• Psychiatric/Mental Health Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.