Lisa Marie Ellison, MA, LMT

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

900 Granby St
Norfolk, VA 23510-2503

Phone

(757) 447-0931

NPI assigned

Nov 9, 2020

Last updated

Aug 23, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Lisa Marie Klingelhoefer Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

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

{
    "created_epoch": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692748800000",
    "number": "1275135972",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1665 LAKE CHRISTOPHER DR",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234647805",
            "telephone_number": "724-601-3027"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 GRANBY ST",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235102503",
            "telephone_number": "757-447-0931"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1421 Kempsville Rd Ste C",
            "address_purpose": "LOCATION",
            "city": "Chesapeake",
            "state": "VA",
            "postal_code": "233201406",
            "country_code": "US",
            "telephone_number": "757-410-5322",
            "fax_number": "757-548-0670",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ELLISON",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "MA, LMT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2023-08-23",
        "certification_date": "2023-08-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "VA",
            "license": "0019013803",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "KLINGELHOEFER",
            "middle_name": "MARIE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Belinda Ellis
• Carl Richard Ellis, ED.D.
• Nicole Ellis, DPT
• Rachel Ellis, PA-S
• Rebecca Ellis, LCSW
• Tierra Domonique Ellison, LPC
• Kelly A Elmhorst, CRNA, DNAP
• Peter Richard Elser, MSPT
• Karen E. Elseroad, L.C.S.W.
• Cassandra Lee Elverum, PA-C

• Counselor in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Counselor in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 23, 2023; 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.