Lisa Blackwell

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

E.2303356 Issued in OH

Practice address

4105 Fulton Dr NW
Canton, OH 44718-2819

Phone

(216) 438-0790

NPI assigned

Nov 19, 2020

Last updated

Sep 8, 2026By 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 1

Addresses

Other names 1

• Lisa Kaser Former name

Medicare fee-for-service enrollment

Enrolled in OH

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

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Avo Behavioral Health LLC

  • Multi-Specialty Clinic/Center
  • Canton, OH
  • NPI 1619590882

  Mental Health

  Medicare reassignment NPD
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  OH

  Medicare reassignment NPD
• Avo Behavioral Health LLC

  • Adult Mental Health Clinic/Center
  • Canton, OH
  • NPI 1104431410
  NPD

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

{
    "created_epoch": "1605744000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788825600000",
    "number": "1659974756",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4105 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182819",
            "telephone_number": "216-438-0790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4105 FULTON DR NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447182819",
            "telephone_number": "216-438-0790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACKWELL",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-11-19",
        "last_updated": "2026-09-08",
        "certification_date": "2026-09-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OH",
            "license": "E.2303356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "KASER",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Jennifer M Blackford, L.M.T.
• Qayonna Nikole Blackmon
• Robin C-a Blackshear
• Christina Blackwell
• Donna Fall Blackwell, BSN, RNC, NNP
• Troy Blagrave, M.D.
• Michele Pollak Blaho, CRNA
• Brian J Blake, M.D.
• Brittany Ann Blake, DPT
• Lynn Blakeney

• Professional Counselor in Canton, OH
• Providers in Canton, OH by specialty
• Professional Counselor in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 8, 2026; 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.