Lisa Clement-Defalco, NP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

0024171905 Issued in VA

Practice address

3155 Earlysville Rd
Earlysville, VA 22936-9561

Phone

(508) 725-7382

NPI assigned

Aug 27, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in DC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: lisaclement-defalco@canmh.allscriptsdirect.net
• Direct secure messaging: lisaclement-defalco@coan.allscriptsdirect.net

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.

• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  DC, Psychiatric/Mental Health

  Medicare reassignment NPD

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1619481600000",
    "number": "1053711044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3155 EARLYSVILLE RD",
            "city": "EARLYSVILLE",
            "state": "VA",
            "postal_code": "229369561",
            "telephone_number": "508-725-7382"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3155 EARLYSVILLE RD",
            "city": "EARLYSVILLE",
            "state": "VA",
            "postal_code": "229369561",
            "telephone_number": "508-725-7382"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CLEMENT-DEFALCO",
        "first_name": "LISA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2021-04-27",
        "certification_date": "2021-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "VA",
            "license": "2014014501",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "VA",
            "license": "0024171905",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• American Institute for Diseases of the Prostate, PLC
• Katharine Pumphrey Appleton, LPC
• James Beatrice, PH,D.
• Margaret Rebecca Antonia Burns, LPC
• Choice Point, LLC
• Anna Tran Dinh, DMD
• Education Transformation Centre
• Gayle Gutierrez, M.D.
• Luis Gutierrez, MD
• Lina Ann Hines, RN, IBCLC

• Psychiatric/Mental Health Nurse Practitioner in Earlysville, VA
• Providers in Earlysville, VA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2021; 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.