Vladimir P Lisenko, LMHC.NCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

LH00010867 Issued in WA

Practice address

750 Lakeshore Dr
Manson, WA 98831-9618

Phone

(206) 714-9710

NPI assigned

Oct 1, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

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

Specialty

Mental Health Counselor

Education

Other, 1976

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

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.

• Behavioral Health Services LLC

  • Mental Health Counselor
  • Issaquah, WA
  • NPI 1801107578

  Mental Health

  NPD (past) Authorized official

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

{
    "created_epoch": "1191196800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1104013390",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 LAKESHORE DR",
            "city": "MANSON",
            "state": "WA",
            "postal_code": "988319618",
            "telephone_number": "206-714-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 LAKESHORE DR",
            "city": "MANSON",
            "state": "WA",
            "postal_code": "988319618",
            "telephone_number": "206-714-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISENKO",
        "first_name": "VLADIMIR",
        "middle_name": "P",
        "credential": "LMHC.NCC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-10-01",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WA",
            "license": "LH00010867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtney Lynn Davidson, LMT
• Aaron Leon England, D.C.
• Deana Dawn Fristad, INTERPRETER
• Rodger Dale Fristad, INTERPRETER
• Marlene Gonzales, DDS
• Brandi Diane Lundberg, LMP
• Manson School District
• Andrea Menin, OT
• Stefanie Morrison, RN
• Dale Reed Peterson, DDS

• All providers in Manson, WA
• Mental Health Counselor in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2024; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.