Lise Leigh Osvold, PH.D., L.P.

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

2675 Issued in NC

Practice address

5500 McNeely Dr
Suite 101
Raleigh, NC 27612-7623

Phone

(919) 787-1240

Fax

(919) 787-1241

NPI assigned

Jul 20, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Opted out of Medicare

Previously, effective Sep 2, 2012 through Sep 2, 2026

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Pembroke Psychological Services LLP

  • Marriage & Family Therapist
  • Raleigh, NC
  • NPI 1184666893

  Counseling

  NPD (past)

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033139456",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "913 W SOUTH ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276032159",
            "telephone_number": "919-787-1240",
            "fax_number": "919-787-1241"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5500 MCNEELY DR",
            "address_2": "SUITE 101",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276127623",
            "telephone_number": "919-787-1240",
            "fax_number": "919-787-1241"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSVOLD",
        "first_name": "LISE",
        "middle_name": "LEIGH",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.P.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-07-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "",
            "desc": "Psychologist, Counseling",
            "state": "NC",
            "license": "2675",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6000547",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lindsay Osterhoudt, HCHD, HCHI
• Jessica Ostheim, RD, LDN
• Holley Ostrander
• Barry S Ostrow, MD
• Osvold Psychotherapy & Testing, Inc.
• Islam Mohamed Othman, M.D.
• Elyse Otten
• Marissa Ann Otten, LGSW
• Hannah Leake Otterman
• Amy Otterson, LPC

• Counseling Psychologist in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Counseling Psychologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.