Individual provider Active NPI

Lisa Kay Herrmann

  • Marriage & Family Therapist
  • Barstow, CA
National Provider Identifier
1053697250
Registry record updated Oct 7, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
147009 Issued in CA
Practice address
222 E Main St. Suite 117
Barstow, CA 92311
Phone
(760) 255-1496
Fax
(760) 255-2542
NPI assigned
Nov 1, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X
Marriage & Family Therapist 106H00000X 119750 CA
Marriage & Family Therapist 106H00000X 147009 CA Primary

Addresses

Primary practice location

222 E Main St. Suite 117
Barstow, CA 92311

Mailing address

222 E Main St Ste 117
Barstow, CA 92311-2365
Phone (760) 255-1496

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
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
I20260310002923 CA Practitioner - Marriage and Family Therapist 1355824129 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2020
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

66 E Flagler St
Miami, FL 33130-1807

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
119750CAMDMarriage & Family Therapist
147009CAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PC Marriage & Family Therapist CurrentSince Jan 27, 2026 Accepting new patients

Organizations & group practices 1

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": "1320105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1728259200000",
    "number": "1053697250",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "222 E MAIN ST STE 117",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "923112365",
            "telephone_number": "760-255-1496",
            "fax_number": "760-255-2542"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "222 E MAIN ST. SUITE 117",
            "city": "BARSTOW",
            "state": "CA",
            "postal_code": "92311",
            "telephone_number": "760-255-1496",
            "fax_number": "760-255-2542"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERRMANN",
        "first_name": "LISA",
        "middle_name": "KAY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-11-01",
        "last_updated": "2024-10-07",
        "certification_date": "2024-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "119750",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "147009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Barstow, CA

Sources for this page

Verify at the official NPI Registry.