Individual provider Active NPI

Lisa Deanne Wold, LPCC

  • Professional Counselor
  • New Brighton, MN
National Provider Identifier
1467600304
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
CC001528 Issued in MN
Practice address
2657 Rice Creek Rd Apt 302
New Brighton, MN 55112-5378
Phone
(208) 249-4238
NPI assigned
Sep 4, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X CC001528 MN Primary

Addresses

Primary practice location

2657 Rice Creek Rd Apt 302
New Brighton, MN 55112-5378

Mailing address

2657 Rice Creek Rd Apt 302
New Brighton, MN 55112-5378
Phone (208) 249-4238

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

State licenses

LicenseStateTypeSpecialty
CC001528MNMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1220486400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1467600304",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2657 RICE CREEK RD APT 302",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551125378",
            "telephone_number": "208-249-4238"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2657 RICE CREEK RD APT 302",
            "city": "NEW BRIGHTON",
            "state": "MN",
            "postal_code": "551125378",
            "telephone_number": "208-249-4238"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOLD",
        "first_name": "LISA",
        "middle_name": "DEANNE",
        "credential": "LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-09-04",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MN",
            "license": "CC001528",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Brighton, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 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.

Verify at the official NPI Registry.