Lisa Antonishek, LLPC
Individual provider Active NPI Counselor · South Lyon, MI
NPI 1083986079 · NPPES record last updated Jan 7, 2026
Key facts
- NPI
- 1083986079
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Counselor 101Y00000X
- License
- 6401011115 (MI)
- Practice address
- 28900 Pontiac TRL
South Lyon, MI 48178-9241 - Phone
- (734) 929-9703
- NPI assigned
- Feb 6, 2012
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2008
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Crossroads Counseling PLLC
Practice addresses (Care Compare)
28900 Pontiac TRL
South Lyon, MI 48178-9241
Phone (734) 929-9703
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in MI, TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260116001593 | MI | Practitioner - Mental Health Counselor | 0941787238 | Reassigns benefits to 2 organizations |
| I20260401001224 | TX | Practitioner - Mental Health Counselor | 0941787238 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401011115 | MI | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Crossroads Counseling, PLLC | Current |
Accepting new patients |
Locations
3830 Packard St
Ste 160
Ann Arbor, MI 48108
Phone (734) 528-9703
28900 Pontiac Trl
South Lyon, MI 48178
Phone (248) 560-7507
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 6401011115 | MI | Yes |
Addresses
Primary practice location
28900 Pontiac TRL
South Lyon, MI 48178-9241
Mailing address
3830 Packard St
Ann Arbor, MI 48108-2051
Phone (734) 929-9703
Other providers in South Lyon, MI
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.