Individual provider Active NPI

Lisa Coppola, MA

  • Mental Health Counselor
  • Bridgewater, NJ
National Provider Identifier
1285046995
Registry record updated May 29, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
500 N Bridge St
Bridgewater, NJ 08807-2135
Phone
(908) 725-2800
Fax
(908) 704-1790
NPI assigned
May 29, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 29, 2014

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

500 N Bridge St
Bridgewater, NJ 08807-2135

Mailing address

500 N Bridge St
Bridgewater, NJ 08807-2135
Phone (908) 725-2800

Other identifiers 1

IdentifierTypeStateIssuer
0023701OtherNJAGENCY MEDICAID PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240209000105 NJ Practitioner - Mental Health Counselor 1153764808 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Lakeside Counseling Associates, LLCGroup PAC ID 0840568754, 26 clinicians

Practice addresses (Care Compare)

30 Moran St
Newton, NJ 07860-1832
Phone (973) 726-4533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeside Counseling Associates, LLC Mental Health CurrentSince Jan 6, 2024 Accepting new patients

Locations

30 Moran St
Newton, NJ 07860
Phone (973) 579-3101

9 Fishers Ln
Ste E
Sparta, NJ 07871
Phone (973) 600-3558

Organizations & group practices 1

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": "1401321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1401321600000",
    "number": "1285046995",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 N BRIDGE ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072135",
            "telephone_number": "908-725-2800",
            "fax_number": "908-704-1790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 N BRIDGE ST",
            "city": "BRIDGEWATER",
            "state": "NJ",
            "postal_code": "088072135",
            "telephone_number": "908-725-2800",
            "fax_number": "908-704-1790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COPPOLA",
        "first_name": "LISA",
        "credential": "MA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-29",
        "last_updated": "2014-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AGENCY MEDICAID PROVIDER NUMBER",
            "identifier": "0023701",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bridgewater, NJ

Sources for this page

Verify at the official NPI Registry.