Individual provider Active NPI

Lisa Koehl, PHD

  • Clinical Neuropsychologist
  • Missoula, MT
National Provider Identifier
1285168260
Registry record updated Jan 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical NeuropsychologistTaxonomy code 103G00000X
License
PSY-PSY-LIC-3744 Issued in MT
Practice address
1622 South Ave W
Missoula, MT 59801-7804
Phone
(406) 543-9700
Fax
(406) 549-8109
NPI assigned
Apr 17, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Neuropsychologist 103G00000X PSY-PSY-LIC-3744 MT Primary

Addresses

Primary practice location

1622 South Ave W
Missoula, MT 59801-7804

Mailing address

1622 South Ave W
Missoula, MT 59801-7804
Phone (406) 543-9700

Other names 1

  • Lisa Mason Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MT
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
I20220120002224 MT Practitioner - Clinical Psychologist 5496012858 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
University of Kentucky College of Medicine, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Montana Neuropsychological Associates PLLCGroup PAC ID 5890084883, 2 clinicians

Practice addresses (Care Compare)

1622 S Ave W
Missoula, MT 59801-7804
Phone (406) 543-9700

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

Practice roles

OrganizationSpecialtyStatusNew patients
Montana Neuropsychological Associates, PLLC CurrentSince Mar 1, 2022 Accepting new patients
RCHP Billings - Missoula LLC PastSince Oct 20, 2024 Accepting new patients

Locations

1622 South Ave W
Missoula, MT 59801
Phone (406) 543-9700

1610 South Ave W
Missoula, MT 59801

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": "1492387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1768953600000",
    "number": "1285168260",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1622 SOUTH AVE W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598017804",
            "telephone_number": "406-543-9700",
            "fax_number": "406-549-8109"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1622 SOUTH AVE W",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598017804",
            "telephone_number": "406-543-9700",
            "fax_number": "406-549-8109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOEHL",
        "first_name": "LISA",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-17",
        "last_updated": "2026-01-21",
        "certification_date": "2026-01-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "",
            "desc": "Clinical Neuropsychologist",
            "state": "MT",
            "license": "PSY-PSY-LIC-3744",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "MASON",
            "credential": "PHD",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Missoula, MT

Sources for this page

Verify at the official NPI Registry.