Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Kimberly Lisack, LCSW

Individual provider Clinical Social Worker · NPI 1558962928

Kimberly Lisack, LCSW is a Clinical Social Worker in Phoenix, Arizona. Qualified in 2001, 25 years ago. Practices with Neighborhood Outreach Access to Health, a 104-clinician group and accepts Medicare assignment. Licensed in Arizona and Connecticut.

Years since qualifying
25
Licensed in
AZ, CT
In the registry since
2020
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

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Practice location Address checks out

9015 N 3rd St
Phoenix, AZ 85020-2444
Phone: (480) 882-4545
Fax: (602) 714-3755
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence LCSW22455 (AZ)
Clinical Social Worker Taxonomy 1041C0700X · Licence 006573 (CT)

Record details

NPI number1558962928
Entity typeIndividual (Type 1)
GenderFemale
Credentials LCSW
Sole proprietorNo
NPI enumeratedNovember 3, 2020
Last updated in NPPESMarch 20, 2025
Certification dateMarch 20, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2001 (25 years in practice)
Group practice Neighborhood Outreach Access To Health — 104 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations4 on file with Medicare

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