Individual provider Active NPI

Lisa Susan Hallock, LCPC

  • Mental Health Counselor
  • Annapolis, MD
National Provider Identifier
1548067259
Registry record updated Feb 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC15565 Issued in MD
Practice address
2124 Bay Front Ter
Annapolis, MD 21409-5705
Phone
(773) 966-9270
NPI assigned
Feb 28, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 28, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 180002220 IL
Mental Health Counselor 101YM0800X LC15565 MD Primary

Addresses

Primary practice location

2124 Bay Front Ter
Annapolis, MD 21409-5705

Mailing address

2124 Bay Front Ter
Annapolis, MD 21409-5705
Phone (773) 966-9270

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

State licenses

LicenseStateTypeSpecialty
180002220ILMDMental Health Counselor
LC15565MDMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1740700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1548067259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2124 BAY FRONT TER",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214095705",
            "telephone_number": "773-966-9270"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2124 BAY FRONT TER",
            "city": "ANNAPOLIS",
            "state": "MD",
            "postal_code": "214095705",
            "telephone_number": "773-966-9270"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALLOCK",
        "first_name": "LISA",
        "middle_name": "SUSAN",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-02-28",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180002220",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MD",
            "license": "LC15565",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Annapolis, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.