Active NPI
Lisa Renee Pacheco, LMHC
- Mental Health Counselor
- Indianapolis, IN
National Provider Identifier
1225156284
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 39001143A
- Practice address
- 6950 Hillsdale Court
Indianapolis, IN 46250-2040 - Phone
- (317) 621-7740
- NPI assigned
- Mar 27, 2007
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 39001143A | IN | Primary |
Addresses
Primary practice location
6950 Hillsdale Court
Indianapolis, IN 46250-2040
Mailing address
7202 Avondale Dr
Avon, IN 46123-9475
Phone (317) 272-3811
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 100270530A | Medicaid | IN |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 39001143A | IN | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174953600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1513814400000",
"number": "1225156284",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7202 AVONDALE DR",
"city": "AVON",
"state": "IN",
"postal_code": "461239475",
"telephone_number": "317-272-3811"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6950 HILLSDALE COURT",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462502040",
"telephone_number": "317-621-7740"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PACHECO",
"first_name": "LISA",
"middle_name": "RENEE",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-03-27",
"last_updated": "2017-12-21",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "IN",
"license": "39001143A",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "100270530A",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.