Lisa Jane Havelin, LMFT

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

1991 Issued in MN

Practice address

572 Lincoln Ave Apt 11
Saint Paul, MN 55102-2835

Phone

(651) 230-4035

NPI assigned

Mar 23, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Lisa Jane Phelps Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1616457600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616457600000",
    "number": "1275119752",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 LINCOLN AVE APT 11",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022835",
            "telephone_number": "651-230-4035"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "572 LINCOLN AVE APT 11",
            "city": "SAINT PAUL",
            "state": "MN",
            "postal_code": "551022835",
            "telephone_number": "651-230-4035"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAVELIN",
        "first_name": "LISA",
        "middle_name": "JANE",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-03-23",
        "last_updated": "2021-03-23",
        "certification_date": "2021-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "MN",
            "license": "1991",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "PHELPS",
            "middle_name": "JANE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Marriage & Family Therapist in Saint Paul, MN
• Providers in Saint Paul, MN by specialty
• Marriage & Family Therapist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 2021; 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.