Lisa R Richardson, LMHC, LPC, NBCC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH11228 Issued in FL

Practice address

1505 Tamiami TRL S Ste 402
Venice, FL 34285-5563

Phone

(941) 882-0590

Fax

(941) 444-0602

NPI assigned

Feb 20, 2019

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Lisa R Willis Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Spirited Away Art Therapy, LLC

  • Mental Health Counselor
  • Venice, FL
  • NPI 1205176609
  NPD Authorized official

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

{
    "created_epoch": "1550620800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550620800000",
    "number": "1477019974",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1607 LARCHWOOD DR",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342931016",
            "telephone_number": "941-882-0590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1505 TAMIAMI TRL S STE 402",
            "city": "VENICE",
            "state": "FL",
            "postal_code": "342855563",
            "telephone_number": "941-882-0590",
            "fax_number": "941-444-0602"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "LISA",
        "middle_name": "R",
        "credential": "LMHC, LPC, NBCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-02-20",
        "last_updated": "2019-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "001923",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH11228",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WILLIS",
            "middle_name": "R",
            "credential": "LPC, NBCC",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wayne Walker Rice, DC
• Richard a. Conroy,M.D.PA (Oasis Eye Care)
• Richard D. Paolillo,MD LLC
• Richard R. Namikas, M.S., CCC-a, Inc.
• Alyssa Richardson
• Mark Richardson
• Hobart Kaye Richey, M.D.
• Ricky Simovitz MD PA
• Timothy Keith Riesz, D.M.D.
• Michelle Rinas, DC

• Mental Health Counselor in Venice, FL
• Providers in Venice, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2019; 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.