Lisa Lamancusa Ma, LLP

Primary specialty

Counseling PsychologistTaxonomy code 103TC1900X

License

6301012462 Issued in MI

Legal business name

LISA LAMANCUSA MA, LLP

Practice address

4829 E Beltline Ave NE Ste 100
Grand Rapids, MI 49525-9349

Phone

(616) 364-3301

NPI assigned

Apr 26, 2018

Organization subpart

No

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

Authorized official

Name

Lisa Lamancusa, LIMITED LICENSED PSY

Title

Business Owner

Phone

(616) 364-3301

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1524700800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524700800000",
    "number": "1124516000",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4829 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259349",
            "telephone_number": "616-364-3301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4829 E BELTLINE AVE NE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495259349",
            "telephone_number": "616-364-3301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA LAMANCUSA MA, LLP",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-04-26",
        "last_updated": "2018-04-26",
        "status": "A",
        "authorized_official_last_name": "LAMANCUSA",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "616-364-3301",
        "authorized_official_credential": "LIMITED LICENSED PSY"
    },
    "taxonomies": [
        {
            "code": "103TC1900X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Counseling",
            "state": "MI",
            "license": "6301012462",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Counseling Psychologist in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Counseling Psychologist in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.