Lisa Summerlin, PMHNP-BC

Primary specialty

Adult Psychiatric/Mental Health Clinical Nurse SpecialistTaxonomy code 364SP0809X

License

R191100 Issued in MD

Practice address

1814 Bel Air Rd Ste 300
Fallston, MD 21047-2730

Phone

(443) 996-5870

NPI assigned

Oct 18, 2013

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Speakeasy Health and Wellness

  • Psychiatric/Mental Health Nurse Practitioner
  • Fallston, MD
  • NPI 1760211999
  NPD Authorized official

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

{
    "created_epoch": "1382054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717459200000",
    "number": "1083042519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 372",
            "city": "HAMPSTEAD",
            "state": "MD",
            "postal_code": "210740372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1814 BEL AIR RD STE 300",
            "city": "FALLSTON",
            "state": "MD",
            "postal_code": "210472730",
            "telephone_number": "443-996-5870"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SUMMERLIN",
        "first_name": "LISA",
        "credential": "PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-10-18",
        "last_updated": "2024-06-04",
        "certification_date": "2024-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MD",
            "license": "R191100",
            "primary": false
        },
        {
            "code": "364SP0809X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Adult",
            "state": "MD",
            "license": "R191100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Danielle Spitelle
• Statcare Group II, PC
• Ross Edward Stauffer, DMD
• Stephen H Getz. O.D.
• Lauren A Stuart, PHARMD
• Liane Scarlett Sweeney, FNP-C
• Leslie Ann Taylor, CRNP-PMH
• Rosema Jackielyn Taylor
• The Fallston Volunteer Fire and Ambulance Company, Inc.
• Kristi Eliza Thrailkill, LCSW-C

• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Fallston, MD
• Providers in Fallston, MD by specialty
• Adult Psychiatric/Mental Health Clinical Nurse Specialist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.