NPIMap

Individual provider Active NPI

Lisa Marie Eimers, LPC-IT, SAC-IT

  • Mental Health Counselor
  • Wauwatosa, WI
National Provider Identifier
1306189196
Registry record updated Dec 8, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1566226 Issued in WI
Practice address
10012 W Capitol Dr
Wauwatosa, WI 53222-1338
Phone
(414) 810-4844
Fax
(414) 810-4845
NPI assigned
Apr 1, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 8, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 16857130 WI
Mental Health Counselor 101YM0800X 1566226 WI Primary

Addresses

Primary practice location

10012 W Capitol Dr
Wauwatosa, WI 53222-1338

Mailing address

10012 W Capitol Dr
Wauwatosa, WI 53222-1338
Phone (414) 810-4844

Other identifiers 2

IdentifierTypeStateIssuer
1566226MedicaidWI
16857130MedicaidWI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
16857130WIMDAddiction (Substance Use Disorder) Counselor
1566226WIMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Mental Health Current Accepting new patients
West Grove Clinic, SC PastSince Oct 30, 2024 Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lisaeimers@tdh.allscriptsdirect.net

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": "1364774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1417996800000",
    "number": "1306189196",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10012 W CAPITOL DR",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532221338",
            "telephone_number": "414-810-4844",
            "fax_number": "414-810-4845"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10012 W CAPITOL DR",
            "city": "WAUWATOSA",
            "state": "WI",
            "postal_code": "532221338",
            "telephone_number": "414-810-4844",
            "fax_number": "414-810-4845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EIMERS",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "LPC-IT, SAC-IT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-04-01",
        "last_updated": "2014-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "WI",
            "license": "16857130",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "WI",
            "license": "1566226",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1566226",
            "state": "WI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "16857130",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Wauwatosa, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2014; 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.