Lisa Marie Haack, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

004345 Issued in NY

Practice address

20 Apple Blossom LN
East Patchogue, NY 11772-4612

Phone

(631) 988-8592

NPI assigned

Mar 15, 2023

Last updated

Mar 15, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

State licenses

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

{
    "created_epoch": "1678838400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678838400000",
    "number": "1356042527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 APPLE BLOSSOM LN",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724612",
            "telephone_number": "631-988-8592"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 APPLE BLOSSOM LN",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117724612",
            "telephone_number": "631-988-8592"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAACK",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-03-15",
        "last_updated": "2023-03-15",
        "certification_date": "2023-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "004345",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mikhail Grzhibek, M.D.
• Julie Guarascio, PSY.D.
• Ruth Lorena Guevara, M.D.
• Irma Gugliotti, PT
• Ashutosh Gupta, M.D.
• Denise Haberle-Kroog, D.O.
• Joanna Marie Haff, PHARMD
• Moataz Yousef Haggag, M.D.
• Denise Hall
• Ping Hao, PHYSICIAN ASSISTANT

• Mental Health Counselor in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2023; 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.