Lisa C. Medina, LCDC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

11182 Issued in TX

Practice address

5808 Balcones Dr
201
Austin, TX 78731-4255

Phone

(512) 804-3650

Fax

(512) 476-0217

NPI assigned

Oct 26, 2010

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 names 1

• Lisa Michelle Carrillo Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1352073600000",
    "number": "1023318813",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2010 ROCKLAND DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787483066",
            "telephone_number": "512-809-6390",
            "fax_number": "512-454-5039"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5808 BALCONES DR",
            "address_2": "201",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787314255",
            "telephone_number": "512-804-3650",
            "fax_number": "512-476-0217"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDINA",
        "first_name": "LISA",
        "middle_name": "C.",
        "credential": "LCDC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2012-11-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "11182",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "CARRILLO",
            "middle_name": "MICHELLE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Filiberto Arturo Medina, LPC
• Inglan Medina, APRN-PNP
• Jeannette Medina
• Karina Medina, RN, IBCLC
• Kylee Medina
• Maranda Medina, LCSW
• Maria S Medina, APN WHNP
• Martha Juliana Medina
• Melinda Rebecca Medina, PA-C
• Patricia Medina

• Addiction (Substance Use Disorder) Counselor in Austin, TX
• Providers in Austin, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2012; 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.