Active NPI
Lisa Wilks, M.A., LPC, LCPC
- Counselor
- Largo, MD
National Provider Identifier
1598125155
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- Practice address
- 1300 Mercantile LN Ste 100M
Largo, MD 20774-5390 - Phone
- (202) 600-1403
- NPI assigned
- Feb 25, 2016
- 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 7
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | PRC14749 | DC | |
| Counselor | 101Y00000X | LC7708 | MD | |
| Mental Health Counselor | 101YM0800X | PRC14749 | DC | |
| Mental Health Counselor | 101YM0800X | LC7708 | MD | |
| Professional Counselor | 101YP2500X | PRC14749 | DC | |
| Professional Counselor | 101YP2500X | LC7708 | MD | |
| Counselor | 101Y00000X | Primary |
Addresses
Primary practice location
1300 Mercantile LN Ste 100M
Largo, MD 20774-5390
Mailing address
1300 Mercantile LN
Suite 100-M
Largo, MD 20774-5327
Phone (202) 600-1403
Other practice location 1
1501 S. Clinton Street Mailstop CT 05-13
Mailstop CT 05-13
Baltimore, MD 21224
Phone (443) 890-7045
Other practice location 2
1629 K St NW
Suite 300
Washington, DC 20006-1602
Phone (202) 600-1403
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| LC7708 | Other | MD | LCPC |
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
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PRC14749 | DC | MD | Counselor |
| LC7708 | MD | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1456358400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1546819200000",
"number": "1598125155",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1300 MERCANTILE LN",
"address_2": "SUITE 100-M",
"city": "LARGO",
"state": "MD",
"postal_code": "207745327",
"telephone_number": "202-600-1403"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1300 MERCANTILE LN STE 100M",
"city": "LARGO",
"state": "MD",
"postal_code": "207745390",
"telephone_number": "202-600-1403"
}
],
"practiceLocations": [
{
"address_1": "1501 S. Clinton Street Mailstop CT 05-13",
"address_2": "Mailstop CT 05-13",
"address_purpose": "LOCATION",
"city": "Baltimore",
"state": "MD",
"postal_code": "21224",
"country_code": "US",
"telephone_number": "443-890-7045",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1629 K St NW",
"address_2": "Suite 300",
"address_purpose": "LOCATION",
"city": "Washington",
"state": "DC",
"postal_code": "200061602",
"country_code": "US",
"telephone_number": "202-600-1403",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "WILKS",
"first_name": "LISA",
"credential": "M.A., LPC, LCPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-02-25",
"last_updated": "2019-01-07",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "DC",
"license": "PRC14749",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "MD",
"license": "LC7708",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "DC",
"license": "PRC14749",
"primary": false
},
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MD",
"license": "LC7708",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "DC",
"license": "PRC14749",
"primary": false
},
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "MD",
"license": "LC7708",
"primary": false
},
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "LCPC",
"identifier": "LC7708",
"state": "MD"
}
],
"endpoints": [],
"other_names": []
}Other providers in Largo, MD
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.