Individual provider Active NPI

Liza Raymond, N.P.

  • Psychiatric/Mental Health Nurse Practitioner
  • Detroit, MI
National Provider Identifier
1508915562
Registry record updated May 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4704233473 Issued in MI
Practice address
1500 Scotten St
Detroit, MI 48209-2139
Phone
(313) 849-5504
Fax
(313) 849-5744
NPI assigned
Jan 9, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 1, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 4704233473 MI
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4704233473 MI Primary

Addresses

Primary practice location

1500 Scotten St
Detroit, MI 48209-2139

Mailing address

901 Beryl CT
Rochester Hills, MI 48307-3202

Other identifiers 1

IdentifierTypeStateIssuer
4925016MedicaidMI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101028000786 MI Practitioner - Nurse Practitioner 7911191499 Reassigns benefits to 5 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2005
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Downriver Mental Health Clinic PCGroup PAC ID 7911995139, 289 clinicians

Practice addresses (Care Compare)

1400 Abbot Rd
Suite 400
East Lansing, MI 48823-1900
Phone (517) 882-3732

1760 S Telegraph Rd
Suite 220
Bloomfield Hills, MI 48302-0183
Phone (517) 882-3732

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
4704233473MIMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Washington Urgent Care, PLLC CurrentSince Jun 5, 2016 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Feb 13, 2023 Accepting new patients
Seton Health Corporation of Southeastern Michigan CurrentSince Jan 2, 2018 Accepting new patients
Seton Health Corporation of Southeastern Michigan CurrentSince Jan 2, 2018 Accepting new patients
Elizabeth Lake Urgent Care PLLC CurrentSince Jun 5, 2016 Accepting new patients
Royal Urgent Care, PLLC CurrentSince Oct 11, 2017 Accepting new patients
David Leszkowitz DO PC CurrentSince Dec 7, 2022 Accepting new patients
Downriver Mental Health Clinic PC CurrentSince Feb 13, 2023 Accepting new patients
First Choice Urgent Care PC PastSince Jun 5, 2016 Accepting new patients
Herbert L. Isaac II, M.D. Family Medicine PLLC Past Accepting new patients

Locations

1760 S Telegraph Rd
Ste 220
Bloomfield Hills, MI 48302
Phone (248) 587-7618

1760 S Telegraph Rd
Ste 200
Bloomfield Township, MI 48302

1400 Abbot Rd
Ste 400
East Lansing, MI 48823
Phone (810) 220-2787

46591 Romeo Plank Rd
Ste 133
Macomb, MI 48044
Phone (586) 226-6161

2708 S Rochester Rd
Ste A
Rochester Hills, MI 48307
Phone (248) 309-3344

2632 S Rochester Rd
Unit 70747
Rochester Hills, MI 48307

4080 Crooks Rd
Royal Oak, MI 48073
Phone (248) 280-1080

22255 Greenfield Rd
Ste 550
Southfield, MI 48075
Phone (586) 226-6161

7701 26 Mile Rd
Washington, MI 48094
Phone (586) 935-4000

57850 Van Dyke Rd
Ste 100
Washington Twp, MI 48094
Phone (586) 203-2020

2446 Elizabeth Lake Rd
Waterford, MI 48328
Phone (248) 309-3344

9178 Highland Rd
Ste 1
White Lake, MI 48386
Phone (248) 698-1999

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.lizaraymond@150339.advancedmd-direct.com

Organizations & group practices 10

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": "1168300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682899200000",
    "number": "1508915562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "901 BERYL CT",
            "city": "ROCHESTER HILLS",
            "state": "MI",
            "postal_code": "483073202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1500 SCOTTEN ST",
            "city": "DETROIT",
            "state": "MI",
            "postal_code": "482092139",
            "telephone_number": "313-849-5504",
            "fax_number": "313-849-5744"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAYMOND",
        "first_name": "LIZA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-09",
        "last_updated": "2023-05-01",
        "certification_date": "2023-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704233473",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MI",
            "license": "4704233473",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4925016",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Detroit, MI

Sources for this page

Verify at the official NPI Registry.