Active NPI
Lisetta Florence Thomas, LPC
- Mental Health Counselor
- Fort Worth, TX
National Provider Identifier
1588716138
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 18376
- Practice address
- 501 College Ave
Fort Worth, TX 76104-2270 - Phone
- (917) 817-5360
- NPI assigned
- Jan 16, 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | |||
| Professional Counselor | 101YP2500X | |||
| School Counselor | 101YS0200X | NA | TX | |
| Mental Health Counselor | 101YM0800X | 18376 | TX | Primary |
Addresses
Primary practice location
501 College Ave
Fort Worth, TX 76104-2270
Mailing address
1516 Hunting Green Dr
Fort Worth, TX 76134-5544
Phone (817) 568-1419
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| NA | Other | TX | SCHOOL COUNSELOR |
| 42-1648622 | Other | TX | FED TAX ID |
| 18376 | Other | TX | LPC |
| 66915 | Other | TX | NCC |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Jun 5, 2025 through Jun 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 18376 | TX | MD | Dental Hygienist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1168905600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675036800000",
"number": "1588716138",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1516 HUNTING GREEN DR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761345544",
"telephone_number": "817-568-1419"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "501 COLLEGE AVE",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "761042270",
"telephone_number": "917-817-5360"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THOMAS",
"first_name": "LISETTA",
"middle_name": "FLORENCE",
"name_prefix": "Ms.",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-01-16",
"last_updated": "2023-01-30",
"certification_date": "2023-01-30",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": null,
"license": null,
"primary": false
},
{
"code": "101YS0200X",
"taxonomy_group": "",
"desc": "Counselor, School",
"state": "TX",
"license": "NA",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "TX",
"license": "18376",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "SCHOOL COUNSELOR",
"identifier": "NA",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FED TAX ID",
"identifier": "42-1648622",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LPC",
"identifier": "18376",
"state": "TX"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCC",
"identifier": "66915",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Fort Worth, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2023; 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.