Lisa Brooke Shaffer, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY0498 Issued in NV

Practice address

1489 W Warm Springs Rd
Ste 110
Henderson, NV 89014-7367

Phone

(702) 806-8618

Fax

(800) 567-4105

NPI assigned

Nov 27, 2006

Last updated

Jun 11, 2020By the provider in NPPES

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in NV

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

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Grgich PC

  dba Advanced Insight Behavioral Health

  • Psychologist
  • Pahrump, NV
  • NPI 1124081757
  NPD (past)

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

{
    "created_epoch": "1164585600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591833600000",
    "number": "1033285572",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1489 W WARM SPRINGS RD",
            "address_2": "STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147367",
            "telephone_number": "702-806-8618",
            "fax_number": "800-567-4105"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1489 W WARM SPRINGS RD",
            "address_2": "STE 110",
            "city": "HENDERSON",
            "state": "NV",
            "postal_code": "890147367",
            "telephone_number": "702-806-8618",
            "fax_number": "800-567-4105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAFFER",
        "first_name": "LISA",
        "middle_name": "BROOKE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-27",
        "last_updated": "2020-06-11",
        "certification_date": "2020-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NV",
            "license": "PY0498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100510783",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rowena Hiyas Sexon
• Jamie Seymour
• Carly Shadid, MFT
• Shadow Emergency Physicians PLLC
• Kathryn Shaffer
• Shah Healthcare PLLC (Usaid)
• Himansu R Shah, M.D.
• Kenneth Jayendra Shah, M.D.
• Lopa H. Shah, M.D.
• Meika Shah, MD

• Clinical Psychologist in Henderson, NV
• Providers in Henderson, NV by specialty
• Clinical Psychologist in Nevada

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2020; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.