Individual provider Active NPI

Lisa Kay Ballinger

  • Mental Health Counselor
  • Beachwood, OH
National Provider Identifier
1033828884
Registry record updated Nov 6, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
I.2405962 Issued in OH
Practice address
23366 Commerce Park Ste 100B
Beachwood, OH 44122-5801
Phone
(216) 292-2880
NPI assigned
Nov 21, 2022
Last updated
Nov 6, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X I.2405962 OH Primary
Clinical Social Worker 1041C0700X NU
Student in an Organized Health Care Education/Training Program 390200000X S1700018-TRNE OH

Addresses

Primary practice location

23366 Commerce Park Ste 100B
Beachwood, OH 44122-5801

Mailing address

7185 Hulls CV
Mentor, OH 44060-5106
Phone (440) 488-6066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH
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
I20241119000968 OH Practitioner - Clinical Social Worker 8527593268 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
I.2405962OHMDMental Health Counselor
S1700018-TRNEOHMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Psycho Social Therapies,LTD Clinical CurrentSince Nov 10, 2024 Accepting new patients
Psycho Social Therapies,LTD CurrentSince Nov 4, 2024 Accepting new patients

Locations

23366 Commerce Park
Ste 100B
Beachwood, OH 44122
Phone (216) 292-2880

23715 Mercantile Rd
Ste A203
Beachwood, OH 44122
Phone (216) 292-2880

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1668988800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730851200000",
    "number": "1033828884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7185 HULLS CV",
            "city": "MENTOR",
            "state": "OH",
            "postal_code": "440605106",
            "telephone_number": "440-488-6066",
            "fax_number": "440-953-6101"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "23366 COMMERCE PARK STE 100B",
            "city": "BEACHWOOD",
            "state": "OH",
            "postal_code": "441225801",
            "telephone_number": "216-292-2880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BALLINGER",
        "first_name": "LISA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-21",
        "last_updated": "2024-11-06",
        "certification_date": "2024-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "I.2405962",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "OH",
            "license": "S1700018-TRNE",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Beachwood, OH

Sources for this page

Verify at the official NPI Registry.