Active NPI
Lisa Santiago, MA, LPC
- Counselor
- Fairbanks, AK
National Provider Identifier
1184453482
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 213694
- Practice address
- PO Box 80261
Fairbanks, AK 99708-0261 - Phone
- (321) 300-2880
- NPI assigned
- Jul 26, 2024
- 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 |
|---|---|---|---|---|
| Counselor | 101Y00000X | 213694 | AK | Primary |
Addresses
Primary practice location
PO Box 80261
Fairbanks, AK 99708-0261
Mailing address
PO Box 80261
Fairbanks, AK 99708-0261
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Oct 14, 2024 through Oct 14, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 213694 | AK | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1721952000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1721952000000",
"number": "1184453482",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 80261",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997080261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 80261",
"city": "FAIRBANKS",
"state": "AK",
"postal_code": "997080261",
"telephone_number": "321-300-2880"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SANTIAGO",
"first_name": "LISA",
"credential": "MA, LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-07-26",
"last_updated": "2024-07-26",
"certification_date": "2024-07-26",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Counselor",
"state": "AK",
"license": "213694",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fairbanks, AK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 26, 2024; 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.