Julie Ellen Lysiak, RN MS CS

Primary specialty

Child & Adolescent Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0807X

License

210641 Issued in MA

Practice address

148 Worcester St
West Boylston, MA 01583-1751

Phone

(508) 835-1735

NPI assigned

Feb 4, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science, Registered Nurse

Practice roles

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.

• Pediatric Behavioral Health, LLC

  • Marriage & Family Therapist
  • West Boylston, MA
  • NPI 1487779104
  NPD (past)

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

{
    "created_epoch": "1170547200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346388808",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "24 ASNEBUMSKIT RD",
            "city": "PAXTON",
            "state": "MA",
            "postal_code": "016121351",
            "telephone_number": "508-752-5621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "148 WORCESTER ST",
            "city": "WEST BOYLSTON",
            "state": "MA",
            "postal_code": "015831751",
            "telephone_number": "508-835-1735"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LYSIAK",
        "first_name": "JULIE",
        "middle_name": "ELLEN",
        "name_prefix": "Mrs.",
        "credential": "RN MS CS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0807X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Child & Adolescent",
            "state": "MA",
            "license": "210641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lori a Heyler OD LLC
• Zoribett Lozada
• Lindsey Mae Luksha
• Lutz Child and Family Associates, P.C.
• John Carl Lutz, PSY.D.
• Kaitlin Mackay, BCBA
• Stephanie Malo
• Mama Doris Foundation Inc
• Emily Mandara
• John Bowler Manning Jr., DC

• Child & Adolescent Psychiatric/Mental Health Registered Nurse in West Boylston, MA
• Providers in West Boylston, MA by specialty
• Child & Adolescent Psychiatric/Mental Health Registered Nurse in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.