Active NPI
Lisa Joy Gordon, LCSW, ACSW
- Clinical Social Worker
- Cave Creek, AZ
National Provider Identifier
1992723910
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 15940
- Practice address
- 5904 E Bramble Berry LN
Cave Creek, AZ 85331-1577 - Phone
- (248) 376-5114
- NPI assigned
- Jul 17, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 6801065045 | MI | |
| Clinical Social Worker | 1041C0700X | 15940 | AZ | Primary |
Addresses
Primary practice location
5904 E Bramble Berry LN
Cave Creek, AZ 85331-1577
Mailing address
5904 E Bramble Berry LN
Cave Creek, AZ 85331-1577
Phone (248) 376-5114
Other names 1
- Lisa Joy Marrich
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Apr 1, 2024 through Apr 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 15940 | AZ | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Henry Ford Health Eastwood Behavioral Health | Social Worker | Past | Accepting new patients |
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 and National Provider Directory roles.
-
- Social Worker
- Clinton Township, MI
- NPI 1396787701
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1601164800000",
"number": "1992723910",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5904 E BRAMBLE BERRY LN",
"city": "CAVE CREEK",
"state": "AZ",
"postal_code": "853311577",
"telephone_number": "248-376-5114"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5904 E BRAMBLE BERRY LN",
"city": "CAVE CREEK",
"state": "AZ",
"postal_code": "853311577",
"telephone_number": "248-376-5114"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORDON",
"first_name": "LISA",
"middle_name": "JOY",
"credential": "LCSW, ACSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-07-17",
"last_updated": "2020-09-27",
"certification_date": "2020-09-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "MI",
"license": "6801065045",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "AZ",
"license": "15940",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "MARRICH",
"middle_name": "JOY",
"credential": "MSW, LMSW, ACSW",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Cave Creek, AZ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.