Individual provider Active NPI

Lisa Cook Niebling, PHD, M.ED.

  • Mental Health Counselor
  • Royal Palm Beach, FL
National Provider Identifier
1295853893
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH-4610 Issued in FL
Practice address
11388 Okeechobee Blvd
Royal Palm Beach, FL 33411-8705
Phone
(561) 798-2310
Fax
(561) 798-2477
NPI assigned
Mar 26, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 MH-4610 FL Primary

Addresses

Primary practice location

11388 Okeechobee Blvd
Royal Palm Beach, FL 33411-8705

Mailing address

11388 Okeechobee Blvd
Royal Palm Beach, FL 33411-8705
Phone (561) 798-2310

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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
I20240326003462 FL Practitioner - Mental Health Counselor 7719322858 Reassigns benefits to 1 organization

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
MH-4610FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Banyan Institute, Inc Mental Health CurrentSince Feb 12, 2024 Accepting new patients

Locations

11388 Okeechobee Blvd
Ste B
Royal Palm Beach, FL 33411
Phone (561) 798-2310

11388 Okeechobee Blvd
Royal Palm Beach, FL 33411
Phone (561) 798-2310

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": "1174867200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1295853893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11388 OKEECHOBEE BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118705",
            "telephone_number": "561-798-2310",
            "fax_number": "561-798-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11388 OKEECHOBEE BLVD",
            "city": "ROYAL PALM BEACH",
            "state": "FL",
            "postal_code": "334118705",
            "telephone_number": "561-798-2310",
            "fax_number": "561-798-2477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEBLING",
        "first_name": "LISA",
        "middle_name": "COOK",
        "credential": "PHD, M.ED.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-26",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH-4610",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Royal Palm Beach, FL

Sources for this page

Verify at the official NPI Registry.