Individual provider Active NPI

Lisa Marie Law, MAED,LPC,NCC

  • Mental Health Counselor
  • Winston Salem, NC
National Provider Identifier
1508025925
Registry record updated Sep 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
958 Issued in NC
Practice address
1255 Creekshire Way Ste 270
Winston Salem, NC 27103-3061
Phone
(336) 701-3111
NPI assigned
Jun 2, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 9, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 958 NC Primary

Addresses

Primary practice location

1255 Creekshire Way Ste 270
Winston Salem, NC 27103-3061

Mailing address

1255 Creekshire Way Ste 270
Winston Salem, NC 27103-3061
Phone (336) 701-3111

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240205002927 NC Practitioner - Mental Health Counselor 3072949031 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Wake Forest University School of Medicine, 1985
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Certus Psychiatry and Integrated Care PLLCGroup PAC ID 0244506756, 17 clinicians

Practice addresses (Care Compare)

1255 Creekshire Way
Suite 270
Winston Salem, NC 27103-3061
Phone (336) 701-3111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
958NCMDBehavioral Analyst

Practice roles

OrganizationSpecialtyStatusNew patients
Certus Psychiatry and Integrated Care PLLC CurrentSince Jan 16, 2024 Accepting new patients

Locations

1255 Creekshire Way
Ste 270
Winston Salem, NC 27103
Phone (336) 701-3111

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.

NPI Registry JSON

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

{
    "created_epoch": "1212364800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631145600000",
    "number": "1508025925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1255 CREEKSHIRE WAY STE 270",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033061",
            "telephone_number": "336-701-3111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1255 CREEKSHIRE WAY STE 270",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271033061",
            "telephone_number": "336-701-3111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAW",
        "first_name": "LISA MARIE",
        "name_prefix": "Ms.",
        "credential": "MAED,LPC,NCC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-02",
        "last_updated": "2021-09-09",
        "certification_date": "2021-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "958",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.