Individual provider Active NPI

Lyvonna Vonshell Chisholm

  • Professional Counselor
  • Savannah, GA
National Provider Identifier
1023501640
Registry record updated Oct 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC010074 Issued in GA
Practice address
250 Cromer St
Savannah, GA 31407-4801
Phone
(912) 844-5629
NPI assigned
Jun 8, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 10, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC010074 GA Primary
Mental Health Counselor 101YM0800X

Addresses

Primary practice location

250 Cromer St
Savannah, GA 31407-4801

Mailing address

250 Cromer St
Savannah, GA 31407-4801
Phone (912) 844-5629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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
I20250314000306 GA Practitioner - Mental Health Counselor 6901328483 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Curtis V. Cooper Primary Health Care, Inc.Group PAC ID 4789667015, 32 clinicians

Practice addresses (Care Compare)

106 E Broad St
Savannah, GA 31401-2917
Phone (912) 527-1000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Curtis V. Cooper Primary Health Care, Inc Current Accepting new patients
Curtis V. Cooper Primary Health Care Inc. CurrentSince Jan 1, 2025 Accepting new patients
Curtis V. Cooper Primary Health Care Inc. Current Accepting new patients
Curtis V. Cooper Primary Health Care, Inc CurrentSince Jan 1, 2025 Accepting new patients

Locations

304 Stephenson Ave
Savannah, GA 31405

1501 Abercorn St
Savannah, GA 31401
Phone (912) 233-7970

106 E Broad St
Savannah, GA 31401
Phone (912) 527-1100

2 Roberts St
Savannah, GA 31408
Phone (912) 527-1100

1451 Highway 21 S
Ste H
Springfield, GA 31329
Phone (912) 754-1035

Organizations & group practices 4

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": "1528416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728518400000",
    "number": "1023501640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 CROMER ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314074801",
            "telephone_number": "912-844-5629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 CROMER ST",
            "city": "SAVANNAH",
            "state": "GA",
            "postal_code": "314074801",
            "telephone_number": "912-844-5629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHISHOLM",
        "first_name": "LYVONNA",
        "middle_name": "VONSHELL",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-06-08",
        "last_updated": "2024-10-10",
        "certification_date": "2024-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC010074",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Savannah, GA

Sources for this page

Verify at the official NPI Registry.