Organization Active NPI

Lisa Ferretti Lisw LLC

  • Mental Health Counselor
  • Cedar Rapids, IA
National Provider Identifier
1700348265
Registry record updated Jul 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LISA FERRETTI LISW LLC
Practice address
1221 Park PL NE Ste F
Cedar Rapids, IA 52402-2019
Phone
(319) 440-0751
Fax
(319) 409-8071
NPI assigned
Apr 3, 2019
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 12, 2022

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

Authorized official

Name
Lisa FerrettiNPI 1912398835
Title
Owner
Phone
(319) 440-0751

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1221 Park PL NE Ste F
Cedar Rapids, IA 52402-2019

Mailing address

1221 Park PL NE Ste F
Cedar Rapids, IA 52402-2019
Phone (319) 440-0751

Other identifiers 1

IdentifierTypeStateIssuer
104339000MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190423000984 IA Part B Supplier - Clinic/Group Practice 2062754062 Receives reassigned benefits from 2 practitioners
Practice locations: Cedar Rapids, IA

National Provider Directory

National Provider Directory

Locations

1221 Park Pl NE
Ste F
Cedar Rapids, IA 52402
Phone (319) 364-8741

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1554249600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1657584000000",
    "number": "1700348265",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1221 PARK PL NE STE F",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022019",
            "telephone_number": "319-440-0751",
            "fax_number": "319-409-8071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1221 PARK PL NE STE F",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524022019",
            "telephone_number": "319-440-0751",
            "fax_number": "319-409-8071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA FERRETTI LISW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-04-03",
        "last_updated": "2022-07-12",
        "certification_date": "2022-07-12",
        "status": "A",
        "authorized_official_last_name": "FERRETTI",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "319-440-0751"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "104339000",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Cedar Rapids, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.