Individual provider Active NPI

Lisa Elaine Sells, LMHCA

  • Mental Health Counselor
  • Fort Wayne, IN
National Provider Identifier
1114703741
Registry record updated Feb 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
39005324A Issued in IN
Practice address
12948 Coldwater Rd Ste 101
Fort Wayne, IN 46845-8016
Phone
(260) 373-0880
Fax
(260) 373-0881
NPI assigned
Sep 8, 2023
Last updated
Feb 24, 2025By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 24, 2025

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 39005324A IN Primary

Addresses

Primary practice location

12948 Coldwater Rd Ste 101
Fort Wayne, IN 46845-8016

Mailing address

12948 Coldwater Rd Ste 101
Fort Wayne, IN 46845-8016
Phone (260) 373-0880

Other names 1

  • Lisa Elaine Charlesworth Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20250308000096 IN Practitioner - Mental Health Counselor 9931620861 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aberdeen Group LLCGroup PAC ID 5597922757, 12 clinicians

Practice addresses (Care Compare)

12948 Coldwater Rd
Suite 101
Fort Wayne, IN 46845-8016
Phone (260) 373-0880

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Aberdeen Group LLC CurrentSince Feb 17, 2025 Accepting new patients
Aberdeen Group LLC CurrentSince Sep 10, 2023 Accepting new patients

Locations

12948 Coldwater Rd
Ste 101
Fort Wayne, IN 46845
Phone (260) 373-0880

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1694131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740355200000",
    "number": "1114703741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12948 COLDWATER RD STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458016",
            "telephone_number": "260-373-0880",
            "fax_number": "260-373-0881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12948 COLDWATER RD STE 101",
            "city": "FORT WAYNE",
            "state": "IN",
            "postal_code": "468458016",
            "telephone_number": "260-373-0880",
            "fax_number": "260-373-0881"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELLS",
        "first_name": "LISA",
        "middle_name": "ELAINE",
        "credential": "LMHCA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-09-08",
        "last_updated": "2025-02-24",
        "certification_date": "2025-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IN",
            "license": "39005324A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "CHARLESWORTH",
            "middle_name": "ELAINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Fort Wayne, IN

Sources for this page

Verify at the official NPI Registry.