Individual provider Active NPI

Lisa Ann Johnson, M.A., LPC, RPT

  • Professional Counselor
  • Colorado Springs, CO
National Provider Identifier
1487139051
Registry record updated Sep 20, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC.0012514 Issued in CO
Practice address
3715 Parkmoor Village Dr Ste 102
Colorado Springs, CO 80917-5200
Phone
(719) 440-8361
NPI assigned
Sep 30, 2018
Last updated
Sep 20, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 20, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LPC.0012514 CO
Professional Counselor 101YP2500X LPC.0012514 CO Primary

Addresses

Primary practice location

3715 Parkmoor Village Dr Ste 102
Colorado Springs, CO 80917-5200

Mailing address

1102 Tulip PL
Colorado Springs, CO 80907-3709
Phone (719) 440-8361

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
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
I20240125004381 CO Practitioner - Mental Health Counselor 2365895380 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Family Care Center LLCGroup PAC ID 5991064420, 703 clinicians

Practice addresses (Care Compare)

2860 S Circle Dr
Colorado Springs, CO 80906-4195
Phone (719) 540-2100

3715 Parkmoor Village Dr
Suite 102
Colorado Springs, CO 80917-5200
Phone (719) 540-2100

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
LPC.0012514COMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Family Care Center, LLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients
Family Care Center, LLC CurrentSince Jan 1, 2024 Accepting new patients
Inner Hope Therapy Current Accepting new patients

Locations

2860 S Circle Dr
Ste 109
Colorado Springs, CO 80906
Phone 71954021004002

3715 Parkmoor Village Dr
Ste 102
Colorado Springs, CO 80917
Phone (719) 540-2127

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1538265600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663632000000",
    "number": "1487139051",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1102 TULIP PL",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809073709",
            "telephone_number": "719-440-8361"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3715 PARKMOOR VILLAGE DR STE 102",
            "city": "COLORADO SPRINGS",
            "state": "CO",
            "postal_code": "809175200",
            "telephone_number": "719-440-8361"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHNSON",
        "first_name": "LISA",
        "middle_name": "ANN",
        "credential": "M.A., LPC, RPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-09-30",
        "last_updated": "2022-09-20",
        "certification_date": "2022-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CO",
            "license": "LPC.0012514",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CO",
            "license": "LPC.0012514",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colorado Springs, CO

Sources for this page

Verify at the official NPI Registry.