Lisa Rae Anderson Mangan, LCPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LCPC 762 Issued in MT

Practice address

120 23Rd Ave NE
Great Falls, MT 59404-1445

Phone

(406) 453-6784

Fax

(406) 453-6793

NPI assigned

Jun 30, 2005

Last updated

Apr 1, 2008By the provider in NPPES

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

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1120089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207008000000",
    "number": "1699772079",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 23RD AVE NE",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594041445",
            "telephone_number": "406-453-6784",
            "fax_number": "406-453-6793"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 23RD AVE NE",
            "city": "GREAT FALLS",
            "state": "MT",
            "postal_code": "594041445",
            "telephone_number": "406-453-6784",
            "fax_number": "406-453-6793"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON MANGAN",
        "first_name": "LISA",
        "middle_name": "RAE",
        "name_prefix": "Ms.",
        "credential": "LCPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-30",
        "last_updated": "2008-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MT",
            "license": "LCPC 762",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0252331",
            "state": "MT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "074938",
            "state": "MT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachel E Amthor, MD
• Anchored PLLC (Open Door Wellness Center)
• Tamra Ann Anderegg, OTR/L
• Anderson Family Pharmacy Inc (Anderson Specialty Pharmacy)
• Anderson Family Pharmacy Inc (Anderson Family Pharmacy)
• Alora D Anderson, AUD
• Amy Anderson
• David E Anderson, MD
• Eric J. Anderson, MD
• Fred E. Anderson, D.M.D.

• Professional Counselor in Great Falls, MT
• Providers in Great Falls, MT by specialty
• Professional Counselor in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2008; 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.