Active NPI
Lisa Lyn Hargrove, LCMHC, LCAS
- Professional Counselor
- Wake Forest, NC
National Provider Identifier
1376990887
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 12065
- Practice address
- 235 Sugar Maple Ave
Wake Forest, NC 27587-2280 - Phone
- (919) 593-5445
- NPI assigned
- May 16, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 21906 | NC | |
| Mental Health Counselor | 101YM0800X | 068.0135520TELE | VT | |
| Professional Counselor | 101YP2500X | 12065 | NC | Primary |
Addresses
Primary practice location
235 Sugar Maple Ave
Wake Forest, NC 27587-2280
Mailing address
235 Sugar Maple Ave
Wake Forest, NC 27587-2280
Phone (919) 593-5445
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 21906 | NC | MD | Addiction (Substance Use Disorder) Counselor |
| 068.0135520TELE | VT | MD | Mental Health Counselor |
| 12065 | NC | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Brightside Medical, P.C. | Past | Accepting new patients |
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.
-
- Psychiatry Physician
- San Francisco, CA
- NPI 1801355482
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1463356800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1751414400000",
"number": "1376990887",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 SUGAR MAPLE AVE",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275872280",
"telephone_number": "919-593-5445"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 SUGAR MAPLE AVE",
"city": "WAKE FOREST",
"state": "NC",
"postal_code": "275872280",
"telephone_number": "919-593-5445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARGROVE",
"first_name": "LISA LYN",
"credential": "LCMHC, LCAS",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-05-16",
"last_updated": "2025-07-02",
"certification_date": "2025-07-02",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NC",
"license": "21906",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "VT",
"license": "068.0135520TELE",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "12065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Wake Forest, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 2, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.