Individual provider Active NPI

Lisa A Noack

  • Mental Health Counselor
  • Thousand Oaks, CA
National Provider Identifier
1386385201
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11343 Issued in CA
Practice address
2816 Sandhurst Ave
Thousand Oaks, CA 91362-5386
Phone
(805) 208-6857
NPI assigned
Apr 5, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 11343 CA Primary

Addresses

Primary practice location

2816 Sandhurst Ave
Thousand Oaks, CA 91362-5386

Mailing address

2816 Sandhurst Ave
Thousand Oaks, CA 91362-5386
Phone (805) 208-6857

Other practice location 1

155 Granada St Ste N
Camarillo, CA 93010-7725
Phone (805) 987-3162 ext. 14

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251208000766 CA Practitioner - Mental Health Counselor 9234511205 Practice locations: Thousand Oaks, CA

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2816 Sandhurst Ave
Thousand Oaks, CA 91362-5386
Phone (805) 208-6857

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11343CAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1386385201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2816 SANDHURST AVE",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913625386",
            "telephone_number": "805-208-6857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2816 SANDHURST AVE",
            "city": "THOUSAND OAKS",
            "state": "CA",
            "postal_code": "913625386",
            "telephone_number": "805-208-6857"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "155 Granada St Ste N",
            "address_purpose": "LOCATION",
            "city": "Camarillo",
            "state": "CA",
            "postal_code": "930107725",
            "country_code": "US",
            "telephone_number": "805-987-3162 x14",
            "fax_number": "805-715-4483",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "NOACK",
        "first_name": "LISA",
        "middle_name": "A",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "11343",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Thousand Oaks, CA

Sources for this page

Verify at the official NPI Registry.