Individual provider Active NPI

Lisa Michelle Noll, PHD

  • Psychologist
  • Houston, TX
National Provider Identifier
1639347040
Registry record updated Feb 19, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
33612 Issued in TX
Practice address
6621 Fannin St
CCC 1630
Houston, TX 77030-2303
Phone
(832) 822-3700
Fax
(832) 825-4164
NPI assigned
Feb 19, 2008
Last updated
Feb 19, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2008

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X IL
Psychologist 103T00000X 33612 TX Primary

Addresses

Primary practice location

6621 Fannin St
CCC 1630
Houston, TX 77030-2303

Mailing address

6621 Fannin St
CCC 1630
Houston, TX 77030-2303
Phone (832) 822-3700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091027000303 TX Practitioner - Clinical Psychologist 6800933631 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
071.007300ILMDPsychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Texas Children's Physician Group CurrentSince Oct 1, 2009 Accepting new patients

Locations

6621 Fannin St
Houston, TX 77030
Phone (832) 824-1866

6621 Fannin St
#1630
Houston, TX 77030
Phone (832) 822-3700

6621 Fannin St
Ste 1630
Houston, TX 77030

6701 Fannin St
Houston, TX 77030
Phone (832) 822-1764

6701 Fannin St
Ste 1420
Houston, TX 77030
Phone (832) 822-4240

6701 Fannin St
Ste 1630
Houston, TX 77030
Phone (832) 692-1570

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1203379200000",
    "number": "1639347040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "address_2": "CCC 1630",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-822-3700",
            "fax_number": "832-825-4164"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6621 FANNIN ST",
            "address_2": "CCC 1630",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770302303",
            "telephone_number": "832-822-3700",
            "fax_number": "832-825-4164"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NOLL",
        "first_name": "LISA",
        "middle_name": "MICHELLE",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2008-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IL",
            "license": null,
            "primary": false
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "TX",
            "license": "33612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.