Active NPI
Lisbet Brito, LPC
- Mental Health Counselor
- Grandville, MI
National Provider Identifier
1114463593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6401015506
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6401015506 | MI | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Center for Eating Disorders and Mental Wellnes LLC | Professional | Current | Accepting new patients |
| Grace Haven Counseling, LLC | Past | 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.
-
- Professional Counselor
- Kentwood, MI
- NPI 1033920509
-
- Clinical Social Worker
- Grandville, MI
- NPI 1063893907
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
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2018; 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.