Active NPI
Lisa Irene Burroughs, PSYD
- Psychologist
- Wilmington, DE
National Provider Identifier
1356633457
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- PY 60175029
- Practice address
- 1601 Kirkwood Hwy
Wilmington, DE 19805-4917 - Phone
- (302) 633-5364
- NPI assigned
- May 7, 2011
- Last updated
- May 7, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | PY 60175029 | WA | Primary |
Addresses
Primary practice location
1601 Kirkwood Hwy
Wilmington, DE 19805-4917
Mailing address
35 Prangs LN
New Castle, DE 19720-4035
Phone (415) 407-5203
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY 60175029 | WA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1304726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1304726400000",
"number": "1356633457",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "35 PRANGS LN",
"city": "NEW CASTLE",
"state": "DE",
"postal_code": "197204035",
"telephone_number": "415-407-5203"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1601 KIRKWOOD HWY",
"city": "WILMINGTON",
"state": "DE",
"postal_code": "198054917",
"telephone_number": "302-633-5364"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BURROUGHS",
"first_name": "LISA",
"middle_name": "IRENE",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-05-07",
"last_updated": "2011-05-07",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "WA",
"license": "PY 60175029",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wilmington, DE
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 7, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.