Lisa Yeager, LCAC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

87001647A Issued in IN

Practice address

240 Waterfall Dr
Elkhart, IN 46516-3668

Phone

(574) 301-7300

Fax

(574) 301-7303

NPI assigned

May 19, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not 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.

• Victory Clinical Services II LLC

  • Addiction Medicine (Family Medicine) Physician
  • South Bend, IN
  • NPI 1497798284
  NPD (past)

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

{
    "created_epoch": "1621382400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1629642137",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "240 WATERFALL DR",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465163668",
            "telephone_number": "574-301-7300",
            "fax_number": "574-301-7303"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "240 WATERFALL DR",
            "city": "ELKHART",
            "state": "IN",
            "postal_code": "465163668",
            "telephone_number": "574-301-7300",
            "fax_number": "574-301-7303"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "YEAGER",
        "first_name": "LISA",
        "credential": "LCAC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-05-19",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "IN",
            "license": "87001647A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christina R Wyse, BCBA
• Karla Yanes, FNP-C
• Stephanie Yanez
• Jing Yang, CRNA
• Doyle Yeager, MD
• Bradley Yensho
• Diana Yoder, LMHC
• Harley Wayne Yoder, M.D.
• Monica R Yoder, RD, CD
• Natalie Lynn Yoder, CF-SLP

• Addiction (Substance Use Disorder) Counselor in Elkhart, IN
• Providers in Elkhart, IN by specialty
• Addiction (Substance Use Disorder) Counselor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.