Individual provider Active NPI

Lisa Marie Blanchard, M.A.

  • Addiction (Substance Use Disorder) Counselor
  • Worcester, MA
National Provider Identifier
1417096298
Registry record updated Jul 9, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
Practice address
105 Merrick St
Worcester, MA 01609-1937
Phone
(508) 854-3320
Fax
(508) 753-5051
NPI assigned
Feb 6, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 9, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X Primary

Addresses

Primary practice location

105 Merrick St
Worcester, MA 01609-1937

Mailing address

585 Lincoln St
Worcester, MA 01605-1906
Phone (508) 854-3320

Other identifiers 4

IdentifierTypeStateIssuer
1306421MedicaidMA
2220002001OtherMABCBS SUBSTANCE ABUSE
1308785MedicaidMA
M18684OtherMABCBS MENTAL HEALTH

Other names 1

  • Miss Lisa Cummings Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • 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
I20240222001004 MA Practitioner - Mental Health Counselor 9537503198 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Spectrum Health Systems Inc CurrentSince Jan 1, 2024 Accepting new patients
Spectrum Health Systems, Inc CurrentSince Jan 1, 2024 Accepting new patients
Spectrum Health Systems, Inc Addiction (Substance Use Disorder) Past Accepting new patients

Locations

149 Oak St
Westborough, MA 01581

105 Merrick St
Worcester, MA 01609
Phone (508) 425-3439

585 Lincoln St
Worcester, MA 01605
Phone (508) 831-0045

10 Mechanic St
Ste 302
Worcester, MA 01608
Phone (508) 792-5400

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1170720000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1417096298",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "585 LINCOLN ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016051906",
            "telephone_number": "508-854-3320",
            "fax_number": "508-753-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 MERRICK ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091937",
            "telephone_number": "508-854-3320",
            "fax_number": "508-753-5051"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLANCHARD",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "M.A.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-06",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1306421",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS SUBSTANCE ABUSE",
            "identifier": "2220002001",
            "state": "MA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1308785",
            "state": "MA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS MENTAL HEALTH",
            "identifier": "M18684",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "CUMMINGS",
            "prefix": "MISS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Worcester, MA

Sources for this page

Verify at the official NPI Registry.