Active NPI
Lisa Burroughs, PH.D., M.H.E., M.DIV
- Pastoral Counselor
- Bryan, TX
National Provider Identifier
1124473442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pastoral Counselor
- License
- 091LB1326 011909
- Practice address
- 1716 Briarcrest Dr Ste 602
Galleria Village Tower
Bryan, TX 77802-2751 - Phone
- (979) 777-9241
- Fax
- (979) 268-0207
- NPI assigned
- Apr 25, 2016
- 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 |
|---|---|---|---|---|
| Pastoral Counselor | 101YP1600X | 091LB1326 011909 | TX | Primary |
Addresses
Primary practice location
1716 Briarcrest Dr Ste 602
Galleria Village Tower
Bryan, TX 77802-2751
Mailing address
1011 Winding Rd
College Station, TX 77840-6159
Phone (979) 777-9241
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 091LB1326 011909 | TX | MD | Pastoral Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1461542400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1461542400000",
"number": "1124473442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1011 WINDING RD",
"city": "COLLEGE STATION",
"state": "TX",
"postal_code": "778406159",
"telephone_number": "979-777-9241",
"fax_number": "979-268-0207"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1716 BRIARCREST DR STE 602",
"address_2": "GALLERIA VILLAGE TOWER",
"city": "BRYAN",
"state": "TX",
"postal_code": "778022751",
"telephone_number": "979-777-9241",
"fax_number": "979-268-0207"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURROUGHS",
"first_name": "LISA",
"name_prefix": "Dr.",
"credential": "PH.D., M.H.E., M.DIV",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-04-25",
"last_updated": "2016-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP1600X",
"taxonomy_group": "",
"desc": "Counselor, Pastoral",
"state": "TX",
"license": "091LB1326 011909",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bryan, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.