Lisa Walker, LCPC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

180.008731 Issued in IL

Practice address

20200 Governors Dr
107
Olympia Fields, IL 60461-1032

Phone

(708) 906-0205

NPI assigned

Aug 14, 2013

Last updated

Feb 1, 2021By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 4

Addresses

Other names 1

• Dr. Lisa Wallace Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Lisa Wallace

  • Mental Health Counselor
  • Olympia Fields, IL
  • NPI 1427463405

  Addiction (Substance Use Disorder)

  NPD (past)

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

{
    "created_epoch": "1376438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1612137600000",
    "number": "1619300605",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5401 RAPIDAN CT",
            "city": "LOTHIAN",
            "state": "MD",
            "postal_code": "207115724",
            "telephone_number": "708-906-0205"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20200 GOVERNORS DR",
            "address_2": "107",
            "city": "OLYMPIA FIELDS",
            "state": "IL",
            "postal_code": "604611032",
            "telephone_number": "708-906-0205"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "LISA",
        "name_prefix": "Dr.",
        "credential": "LCPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-08-14",
        "last_updated": "2021-02-01",
        "certification_date": "2021-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IL",
            "license": "180.008731",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IL",
            "license": "180.008731",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "IL",
            "license": "180.008731",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC11094",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "WALLACE",
            "prefix": "DR.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Walgreen Co (Walgreens #03651)
• Walgreen Co (Walgreens #07411)
• Walgreen Co. (Walgreens #7411)
• Demetrious Walker
• George Walker, DO
• Mitzi Walker, RN
• Monika Sade Walker, NP
• Paula M Walker
• Staci Walker
• Christopher Walkowiak, CRNA

• Mental Health Counselor in Olympia Fields, IL
• Providers in Olympia Fields, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.