Lisa A Lavelle, M.ED., LSW, LICDC-CS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

LICDC # 933526 Issued in OH

Practice address

4998 W Broad St Ste 104
Columbus, OH 43228-1647

Phone

(614) 754-8051

Fax

(614) 319-6123

NPI assigned

Jan 7, 2010

Sex

Female

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

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 and National Provider Directory roles.

• Landmark Behavioral Health, LLC

  • Behavior Analyst
  • Delaware, OH
  • NPI 1407436231
  NPD (past)

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

{
    "created_epoch": "1262822400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1642377600000",
    "number": "1194055467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 POWHATAN AVE",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432041916",
            "telephone_number": "614-323-2743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4998 W BROAD ST STE 104",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432281647",
            "telephone_number": "614-754-8051",
            "fax_number": "614-319-6123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAVELLE",
        "first_name": "LISA",
        "middle_name": "A",
        "credential": "M.ED., LSW, LICDC-CS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-01-07",
        "last_updated": "2022-01-17",
        "certification_date": "2022-01-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "LSW # S.0011653",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OH",
            "license": "LICDC # 933526",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laury J Dimichaelangelo DDS Inc
• Kaitlyn Mae Laux
• Margot Joseph Lavache Jr.
• Cherealla Lavan
• Lorpu P Lavela
• Rachel Irene Lavelle, PHARMD
• Andrew Lavender
• Jacquelyn Lavender, LCDC III
• Paige Lavender, PHARMD
• Donnalynn Holiday Laver, RN

• Addiction (Substance Use Disorder) Counselor in Columbus, OH
• Providers in Columbus, OH by specialty
• Addiction (Substance Use Disorder) Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 17, 2022; 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.