Active NPI
Lisa A Smith, MS
- Mental Health Counselor
- Bremerton, WA
National Provider Identifier
1235284696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- LH00008137
- Practice address
- 5455 Almira Dr SE
Bremerton, WA 98311-8330 - Phone
- (360) 373-5031
- NPI assigned
- Jan 24, 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 | LH00008137 | WA | Primary |
Addresses
Primary practice location
5455 Almira Dr SE
Bremerton, WA 98311-8330
Mailing address
5455 Almira Dr SE
Bremerton, WA 98311-8330
Phone (360) 373-5031
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 91102010682 | Other | WA | KITSAP PHYSICIANS SERVICE |
Other names 1
- Lisa A Henderson
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 2000
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1400 Pottery Ave
Port Orchard, WA 98366-3711
Phone (360) 895-5000
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LH00008137 | WA | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients | |
| Kaiser Foundation Health Plan of Washington | Current | Accepting new patients |
Locations
1400 Pottery Ave
Port Orchard, WA 98366
Phone (360) 895-5000
200 15th Ave E
Seattle, WA 98112
Phone (206) 326-4530
9505 S Steele St
Tacoma, WA 98444
Phone (253) 597-6800
Interoperability endpoints
- lsmith178634@ghc.direct-ci.net
Organizations & group practices 3
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.
-
- Multi-Specialty Clinic/Center
- Seattle, WA
- NPI 1396810701
-
- Multi-Specialty Clinic/Center
- Everett, WA
- NPI 1386935351
-
- Multi-Specialty Clinic/Center
- Renton, WA
- NPI 1669619870
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1235284696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5455 ALMIRA DR SE",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983118330",
"telephone_number": "360-373-5031"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5455 ALMIRA DR SE",
"city": "BREMERTON",
"state": "WA",
"postal_code": "983118330",
"telephone_number": "360-373-5031"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "LISA",
"middle_name": "A",
"credential": "MS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-24",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "WA",
"license": "LH00008137",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "KITSAP PHYSICIANS SERVICE",
"identifier": "91102010682",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "LISA",
"last_name": "HENDERSON",
"middle_name": "A",
"code": "1",
"type": "Former Name"
}
]
}
Other providers in Bremerton, WA
Sources for this page
- 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; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.