Individual provider Active NPI

Lisbet Brito, LPC

  • Mental Health Counselor
  • Grandville, MI
National Provider Identifier
1114463593
Registry record updated Oct 23, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
6401015506 Issued in MI
Practice address
4565 Wilson Ave SW Ste 4a
Grandville, MI 49418-2371
Phone
(616) 591-9000
Fax
(616) 432-3059
NPI assigned
Jan 10, 2017
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 6401015506 MI Primary

Addresses

Primary practice location

4565 Wilson Ave SW Ste 4a
Grandville, MI 49418-2371

Mailing address

300 68TH St SE
Grand Rapids, MI 49548-6927
Phone (616) 222-6431

Other practice location 1

300 68th St SE
Grand Rapids, MI 49548-6927
Phone (616) 222-6431

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
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
I20250312003735 MI Practitioner - Mental Health Counselor 2567983018 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6401015506MIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Center for Eating Disorders and Mental Wellnes LLC Professional CurrentSince Jan 10, 2025 Accepting new patients
Grace Haven Counseling, LLC PastSince Sep 1, 2017 Accepting new patients

Locations

3230 Broadmoor Ave SE
Ste D
Kentwood, MI 49512
Phone (616) 821-7965

Organizations & group practices 2

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": "1484006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540252800000",
    "number": "1114463593",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 68TH ST SE",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495486927",
            "telephone_number": "616-222-6431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4565 WILSON AVE SW STE 4A",
            "city": "GRANDVILLE",
            "state": "MI",
            "postal_code": "494182371",
            "telephone_number": "616-591-9000",
            "fax_number": "616-432-3059"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 68th St SE",
            "address_purpose": "LOCATION",
            "city": "Grand Rapids",
            "state": "MI",
            "postal_code": "495486927",
            "country_code": "US",
            "telephone_number": "616-222-6431",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRITO",
        "first_name": "LISBET",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-01-10",
        "last_updated": "2018-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MI",
            "license": "6401015506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Grandville, MI

Sources for this page

Verify at the official NPI Registry.