Individual provider Active NPI

Lisa L. Bettencourt, MSW

  • Clinical Social Worker
  • Quincy, MA
National Provider Identifier
1992996664
Registry record updated Aug 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
859 Willard St
Ste 430
Quincy, MA 02169-7482
Phone
(617) 847-1950
Fax
(617) 774-1490
NPI assigned
Aug 7, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 7, 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 Primary

Addresses

Primary practice location

859 Willard St
Ste 430
Quincy, MA 02169-7482

Mailing address

859 Willard St
Ste 430
Quincy, MA 02169-7482
Phone (617) 847-1950

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
South Shore Mental Health Center, Inc. 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.

NPI Registry JSON

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

{
    "created_epoch": "1186444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1186444800000",
    "number": "1992996664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "859 WILLARD ST",
            "address_2": "STE 430",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697482",
            "telephone_number": "617-847-1950",
            "fax_number": "617-774-1490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "859 WILLARD ST",
            "address_2": "STE 430",
            "city": "QUINCY",
            "state": "MA",
            "postal_code": "021697482",
            "telephone_number": "617-847-1950",
            "fax_number": "617-774-1490"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BETTENCOURT",
        "first_name": "LISA",
        "middle_name": "L.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-07",
        "last_updated": "2007-08-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Quincy, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 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.