Individual provider Active NPI

Lisa Ann Firullo, LPC

  • Professional Counselor
  • Davidson, NC
National Provider Identifier
1669424636
Registry record updated Dec 17, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4287 Issued in NC
Practice address
903 Northeast Dr
Suite 301
Davidson, NC 28036-7416
Phone
(704) 941-9419
NPI assigned
May 17, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 17, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4287 NC Primary

Addresses

Primary practice location

903 Northeast Dr
Suite 301
Davidson, NC 28036-7416

Mailing address

PO Box 1467
Cornelius, NC 28031-1467
Phone (704) 941-9419

Other identifiers 1

IdentifierTypeStateIssuer
6102348MedicaidNC

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)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Teladoc Health Medical Group, P.a. Professional Current Accepting new patients

Interoperability endpoints

  • Direct secure messaging: lisafirullo@tdh.allscriptsdirect.net

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1147824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261008000000",
    "number": "1669424636",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1467",
            "city": "CORNELIUS",
            "state": "NC",
            "postal_code": "280311467",
            "telephone_number": "704-941-9419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "903 NORTHEAST DR",
            "address_2": "SUITE 301",
            "city": "DAVIDSON",
            "state": "NC",
            "postal_code": "280367416",
            "telephone_number": "704-941-9419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FIRULLO",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-05-17",
        "last_updated": "2009-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4287",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6102348",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davidson, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2009; 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.