Active NPI
Lisa Hamilton, LPCC
- Professional Counselor
- San Rafael, CA
National Provider Identifier
1508369398
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- LPCC4894
- Practice address
- 129 Greenfield Ave
San Rafael, CA 94901-2622 - Phone
- (415) 420-3282
- NPI assigned
- Mar 17, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | LPC-10947 | AZ | |
| Professional Counselor | 101YP2500X | LPCC4894 | CA | Primary |
Addresses
Primary practice location
129 Greenfield Ave
San Rafael, CA 94901-2622
Mailing address
910 D St Unit 151477
San Rafael, CA 94915-5718
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LPC-10947 | Other | AZ | ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS |
| LPCC4894 | Other | CA | CALIFORNIA BOARD OF BEHAVIORAL SCIENCES |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Nov 1, 2024 through Nov 1, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LPC-10947 | AZ | MD | Professional Counselor |
| LPCC4894 | CA | MD | Professional Counselor |
| 4894 | CA | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1521244800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1508369398",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "910 D ST UNIT 151477",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949155718"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "129 GREENFIELD AVE",
"city": "SAN RAFAEL",
"state": "CA",
"postal_code": "949012622",
"telephone_number": "415-420-3282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HAMILTON",
"first_name": "LISA",
"credential": "LPCC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-17",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "AZ",
"license": "LPC-10947",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "CA",
"license": "LPCC4894",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ARIZONA BOARD OF BEHAVIORAL HEALTH EXAMINERS",
"identifier": "LPC-10947",
"state": "AZ"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA BOARD OF BEHAVIORAL SCIENCES",
"identifier": "LPCC4894",
"state": "CA"
}
],
"endpoints": [],
"other_names": []
}Other providers in San Rafael, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; 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.