Active NPI
Lisa Wohlbruck Mask, LPC,NCC,RN
- Professional Counselor
- Charlotte, NC
National Provider Identifier
1508071630
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- 1079
- Practice address
- 1801 E 5TH St
Suite 106
Charlotte, NC 28204-2379 - Phone
- (704) 377-7454
- NPI assigned
- May 11, 2007
- Sex
- Female
- Sole proprietor
- Yes
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 | 1079 | NC | Primary |
Addresses
Primary practice location
1801 E 5TH St
Suite 106
Charlotte, NC 28204-2379
Mailing address
2941 Hanson Dr
Charlotte, NC 28207-2617
Phone (704) 372-9211
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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1079 | NC | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1508071630",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2941 HANSON DR",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282072617",
"telephone_number": "704-372-9211"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1801 E 5TH ST",
"address_2": "SUITE 106",
"city": "CHARLOTTE",
"state": "NC",
"postal_code": "282042379",
"telephone_number": "704-377-7454"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MASK",
"first_name": "LISA",
"middle_name": "WOHLBRUCK",
"name_prefix": "Mrs.",
"credential": "LPC,NCC,RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "NC",
"license": "1079",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Charlotte, NC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.