Individual provider Active NPI

Lisa Anne Lysne, LCSW

  • Clinical Social Worker
  • Great Falls, MT
National Provider Identifier
1992807507
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
471LCSW Issued in MT
Practice address
410 Central Ave Ste 502
Great Falls, MT 59401-3128
Phone
(406) 727-3152
Fax
(406) 727-3172
NPI assigned
Sep 3, 2006
Last updated
Jul 9, 2007By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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 471LCSW MT Primary

Addresses

Primary practice location

410 Central Ave Ste 502
Great Falls, MT 59401-3128

Mailing address

410 Central Ave Ste 502
Great Falls, MT 59401-3128
Phone (406) 727-3152

Other identifiers 1

IdentifierTypeStateIssuer
0501296MedicaidMT

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20040504001379 MT Practitioner - Clinical Social Worker 5597753913 Practice locations: Great Falls, MT

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1994
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

410 Central Ave
Great Falls, MT 59401-3128
Phone (406) 727-3152

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
471LCSWMTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Merrit Psychiatry PLLC 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, 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": "1157241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1992807507",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "410 CENTRAL AVE STE 502",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013128",
            "telephone_number": "406-727-3152",
            "fax_number": "406-727-3172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "410 CENTRAL AVE STE 502",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594013128",
            "telephone_number": "406-727-3152",
            "fax_number": "406-727-3172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYSNE",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-09-03",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MT",
            "license": "471LCSW",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0501296",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Falls, MT

Sources for this page

Verify at the official NPI Registry.