Active NPI
Lisa Jane Booan, M.ED, ED.S.
- School Psychologist
- Roanoke, VA
National Provider Identifier
1043971856
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 0813001187
- Practice address
- 5901 Plantation Cir
Roanoke, VA 24019-4937 - Phone
- (540) 561-8175
- NPI assigned
- Jan 4, 2022
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Psychologist | 103TS0200X | 0813001187 | VA | Primary |
Addresses
Primary practice location
5901 Plantation Cir
Roanoke, VA 24019-4937
Mailing address
5901 Plantation Cir
Roanoke, VA 24019-4937
Phone (540) 561-8175
Other practice location 1
6758 Northside High School Road
Roanoke, VA 24019
Phone (607) 267-3087
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0813001187 | Other | VA | STATE LICENSE LIMITED |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lbooan@rcps.us | Direct |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Education
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0813001187 | VA | MD | School Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1641254400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1641254400000",
"number": "1043971856",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5901 PLANTATION CIR",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240194937",
"telephone_number": "540-561-8175"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 PLANTATION CIR",
"city": "ROANOKE",
"state": "VA",
"postal_code": "240194937",
"telephone_number": "540-561-8175"
}
],
"practiceLocations": [
{
"address_1": "6758 Northside High School Road",
"address_purpose": "LOCATION",
"city": "Roanoke",
"state": "VA",
"postal_code": "24019",
"country_code": "US",
"telephone_number": "607-267-3087",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "BOOAN",
"first_name": "LISA",
"middle_name": "JANE",
"name_prefix": "Ms.",
"credential": "M.ED, ED.S.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-01-04",
"last_updated": "2022-01-04",
"certification_date": "2022-01-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "VA",
"license": "0813001187",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE LICENSE LIMITED",
"identifier": "0813001187",
"state": "VA"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lbooan@rcps.us",
"affiliation": "N",
"endpointDescription": "business email",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "unknown",
"address_1": "5901 Plantation Cir",
"city": "Roanoke",
"state": "VA",
"country_code": "US",
"postal_code": "240194937",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Roanoke, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.