Lisa A Krock, ED.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

3003 Issued in MA

Practice address

24 Rockland St
Hanover, MA 02339-2226

Phone

(781) 826-8228

Fax

(781) 826-0965

NPI assigned

Dec 12, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 7

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Hanover Chiropractic Health Care LLC

  • Neurology Chiropractor
  • Hanover, MA
  • NPI 1932344694
  NPD (past)

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

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1538220751",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "438 POND ST",
            "city": "WESTWOOD",
            "state": "MA",
            "postal_code": "020902831",
            "telephone_number": "781-826-8228",
            "fax_number": "781-826-0965"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24 ROCKLAND ST",
            "city": "HANOVER",
            "state": "MA",
            "postal_code": "023392226",
            "telephone_number": "781-826-8228",
            "fax_number": "781-826-0965"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KROCK",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Dr.",
        "credential": "ED.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "MA",
            "license": "3003",
            "primary": false
        },
        {
            "code": "103TF0000X",
            "taxonomy_group": "",
            "desc": "Psychologist, Family",
            "state": "MA",
            "license": "3003",
            "primary": false
        },
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "3003",
            "primary": false
        },
        {
            "code": "103TA0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Adult Development & Aging",
            "state": "MA",
            "license": "3003",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "3003",
            "primary": true
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "MA",
            "license": "3003",
            "primary": false
        },
        {
            "code": "103TF0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Forensic",
            "state": "MA",
            "license": "3003",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0510629",
            "state": "MA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Abigail Friend Krug, LIC. AC.
• Connor Raymond Kulka, DMD
• Dennis Kulka, DMD
• Peter Stephen Kulka, D.D.S.
• Micaela Joy Lacasse, PHARM.D.

• Clinical Psychologist in Hanover, MA
• Providers in Hanover, MA by specialty
• Clinical Psychologist in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.

Verify at the official NPI Registry.