Lisa C McElroy, PHD
Individual provider Active NPI Psychologist · Indian River, MI
NPI 1245201581 · NPPES record last updated Mar 5, 2025
Key facts
- NPI
- 1245201581
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychologist 103T00000X
- License
- 34068 (TX)
- Practice address
- 1730 Shawnee Ave
Indian River, MI 49749-8705 - Phone
- (214) 998-4888
- NPI assigned
- Jan 26, 2006
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Psychologist
- Education
- University of Pittsburgh School of Medicine, 1993
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
413 W Bethel Rd
100 Coppell Counseling Center
Coppell, TX 75019-4474
Phone (214) 998-4888
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TX
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20081216000511 | TX | Practitioner - Clinical Psychologist | 9638117153 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 012579 | NY | MD | Psychologist |
| 34068 | TX | MD | Institutional Pharmacy |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lisa C McElroy PHD PLLC | Current |
Accepting new patients | |
| Teladoc Health Medical Group, P.a. | Psychologist | Current | Accepting new patients |
| Lisa C. McElroy, PHD, Psychology, PC | Psychologist | Past | Accepting new patients |
Locations
413 W Bethel Rd
Ste 100
Coppell, TX 75019
Phone (972) 304-8032
Interoperability endpoints
- lisamcelroy@tdh.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 012579 | NY | |
| Psychologist | 103T00000X | 34068 | TX | Yes |
Addresses
Primary practice location
1730 Shawnee Ave
Indian River, MI 49749-8705
Mailing address
1730 Shawnee Ave
Indian River, MI 49749-8705
Phone (214) 998-4888
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01676333 | Medicaid | NY |
Other providers in Indian River, MI
- Marcia Margaret Kosovec
- Janet Marie Ladere
- Carrie Lahaie
- Lighthouse Counseling, PLLC
- Chinita May Palle Long
- Katie Ann Morell
- Elizabeth Joy Morley
- Marshall Walter Morley
- Munson Healthcare Otsego Memorial Hospital
- Munson Healthcare Otsego Memorial Hospital
All providers in Indian River, MI · Psychologist in Michigan
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 5, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.