Individual provider Active NPI

Lisa Diane Heisterkamp Davis, LMHC

  • Mental Health Counselor
  • Arlington, MA
National Provider Identifier
1255614764
Registry record updated Jan 23, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
54 Academy Street
Arlington, MA 02476-6436
Phone
(617) 529-3829
NPI assigned
Sep 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 23, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X Primary

Addresses

Primary practice location

54 Academy Street
Arlington, MA 02476-6436

Mailing address

54 Academy Street
Arlington, MA 02476-6436
Phone (617) 529-3829

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Dec 10, 2024 through Dec 10, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Hospital Corporation Past Accepting new patients
Northeast Behavioral Health Corporation Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737590400000",
    "number": "1255614764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "54 ACADEMY STREET",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024766436",
            "telephone_number": "617-529-3829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "54 ACADEMY STREET",
            "city": "ARLINGTON",
            "state": "MA",
            "postal_code": "024766436",
            "telephone_number": "617-529-3829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HEISTERKAMP DAVIS",
        "first_name": "LISA",
        "middle_name": "DIANE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2025-01-23",
        "certification_date": "2024-12-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, MA

Sources for this page

Verify at the official NPI Registry.