Lisa Anllo, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

013139 Issued in NY

Practice address

406 Linwood Ave
Buffalo, NY 14209-1629

Phone

(716) 886-7304

Fax

(716) 886-7398

NPI assigned

Mar 18, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Sep 21, 2022 through Sep 21, 2026

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Michael B. Leach, PHD, Inc.

  • Clinical Psychologist
  • Twinsburg, OH
  • NPI 1538309455
  NPD (past)

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

{
    "created_epoch": "1174176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174647044",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "406 LINWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142091629",
            "telephone_number": "716-886-7304",
            "fax_number": "716-886-7398"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "406 LINWOOD AVE",
            "city": "BUFFALO",
            "state": "NY",
            "postal_code": "142091629",
            "telephone_number": "716-886-7304",
            "fax_number": "716-886-7398"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANLLO",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-18",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "NY",
            "license": "013139",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Angels Fitness & Nutrition LLC
• Roberta Angielczyk, RN
• Elizabeth Bassler Anibaldi, PA
• Sergio J Anillo, MD
• Mark Alan Ankney, DPM
• Anna Shurmatz L.L.C.
• Diane Smith Annalett, M.D.
• Divya Annamalai, DO
• Esther Annan
• Sana Annan

• Clinical Psychologist in Buffalo, NY
• Providers in Buffalo, NY by specialty
• Clinical Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.