Individual provider Active NPI

Lisa D McGrath, PH.D.

  • Clinical Psychologist
  • O Fallon, MO
National Provider Identifier
1033354501
Registry record updated Dec 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
2001000880 Issued in MO
Practice address
7400 Highway N
O Fallon, MO 63368-7013
Phone
(636) 561-7080
NPI assigned
Dec 11, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 11, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 2001000880 MO Primary

Addresses

Primary practice location

7400 Highway N
O Fallon, MO 63368-7013

Mailing address

7400 Highway N
O Fallon, MO 63368-7013
Phone (636) 561-7080

Other identifiers 1

IdentifierTypeStateIssuer
495366924MedicaidMO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
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
I20040213000270 MO Practitioner - Clinical Psychologist 0143114660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Family Life Counseling and Psychological Services LLCGroup PAC ID 5496649022, 5 clinicians

Practice addresses (Care Compare)

4142 Keaton Crossing Blvd
Suite 101
O Fallon, MO 63368-8406
Phone (636) 300-9333

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Family Life Counseling and Psychological Services, LLC CurrentSince Mar 1, 2003 Accepting new patients
David a. Lipsitz, PH.D., Inc Clinical PastSince Nov 1, 2010 Accepting new patients
Psychological Network, Inc. PastSince Dec 27, 2011 Accepting new patients

Locations

4142 Keaton Crossing Blvd
Ste 101
O Fallon, MO 63368
Phone (636) 300-9333

Organizations & group practices 3

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": "1228953600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228953600000",
    "number": "1033354501",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7400 HIGHWAY N",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687013",
            "telephone_number": "636-561-7080"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7400 HIGHWAY N",
            "city": "O FALLON",
            "state": "MO",
            "postal_code": "633687013",
            "telephone_number": "636-561-7080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRATH",
        "first_name": "LISA",
        "middle_name": "D",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-11",
        "last_updated": "2008-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MO",
            "license": "2001000880",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "495366924",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in O Fallon, MO

Sources for this page

Verify at the official NPI Registry.