John J Lisy Jr., LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I0000993 Issued in OH

Practice address

24500 Center Ridge Rd Ste 110
Westlake, OH 44145-5604

Phone

(440) 787-6311

NPI assigned

Mar 13, 2023

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Tree of Life Counseling and Training Center, Inc.

  • Professional Counselor
  • Westlake, OH
  • NPI 1902320203
  Medicare reassignment NPD

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

{
    "created_epoch": "1678665600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1144921677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2419 DERBYSHIRE RD",
            "city": "CLEVELAND HTS",
            "state": "OH",
            "postal_code": "441062725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24500 CENTER RIDGE RD STE 110",
            "city": "WESTLAKE",
            "state": "OH",
            "postal_code": "441455604",
            "telephone_number": "440-787-6311"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISY",
        "first_name": "JOHN",
        "middle_name": "J",
        "name_suffix": "Jr.",
        "credential": "LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-03-13",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OH",
            "license": "E0000387",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I0000993",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angela Marie Lilley, MS, CCC-SLP
• Tracy A Lim, MD
• Beth E Lin, O.D.
• Paul Willard Lindgren, DDS
• Brianna Marie Lindsey, CNP
• Jason Little, CNP
• Eric Livingston, RBT
• Amelia V Llerena, MD
• Jayden Lloyd
• Curtis Major Lockhart, M.D.

• Clinical Social Worker in Westlake, OH
• Providers in Westlake, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2023; 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.

Verify at the official NPI Registry.