Active NPI
Lisa G Poore, MS, LPC
- Professional Counselor
- Suwanee, GA
National Provider Identifier
1497046486
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPC001741
- Practice address
- 3905 Johns Creek CT
Suite 260
Suwanee, GA 30024-1224 - Phone
- (770) 753-0350
- Fax
- (770) 497-9536
- NPI assigned
- Apr 25, 2011
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC001741 | GA | Primary |
Addresses
Primary practice location
3905 Johns Creek CT
Suite 260
Suwanee, GA 30024-1224
Mailing address
3905 Johns Creek CT
Suite 260
Suwanee, GA 30024-1224
Phone (770) 753-0350
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jan 1, 2024 through Jan 1, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC001741 | GA | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Paraclete Counseling Center, Inc | Professional | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Professional Counselor
- Suwanee, GA
- NPI 1972641538
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1303689600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1303689600000",
"number": "1497046486",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3905 JOHNS CREEK CT",
"address_2": "SUITE 260",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300241224",
"telephone_number": "770-753-0350",
"fax_number": "770-497-9536"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3905 JOHNS CREEK CT",
"address_2": "SUITE 260",
"city": "SUWANEE",
"state": "GA",
"postal_code": "300241224",
"telephone_number": "770-753-0350",
"fax_number": "770-497-9536"
}
],
"practiceLocations": [],
"basic": {
"last_name": "POORE",
"first_name": "LISA",
"middle_name": "G",
"name_prefix": "Ms.",
"credential": "MS, LPC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-04-25",
"last_updated": "2011-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "GA",
"license": "LPC001741",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Suwanee, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.