Individual provider Active NPI

Lisa Cottrell, L.P.C.

  • Professional Counselor
  • Decatur, GA
National Provider Identifier
1720353659
Registry record updated Mar 10, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC004983 Issued in GA
Practice address
601 W Ponce de Leon Ave
Decatur, GA 30030-2952
Phone
(404) 931-3066
NPI assigned
Mar 10, 2012
Last updated
Mar 10, 2012By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 10, 2012

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 LPC004983 GA Primary

Addresses

Primary practice location

601 W Ponce de Leon Ave
Decatur, GA 30030-2952

Mailing address

PO Box 465
Avondale Estates, GA 30002-0465
Phone (404) 931-3066

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 24, 2024 through Jan 24, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
LPC004983GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Well Being Psychotherapy LLC Professional Past Accepting new patients

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": "1331337600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1331337600000",
    "number": "1720353659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 465",
            "city": "AVONDALE ESTATES",
            "state": "GA",
            "postal_code": "300020465",
            "telephone_number": "404-931-3066"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 W PONCE DE LEON AVE",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300302952",
            "telephone_number": "404-931-3066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COTTRELL",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "L.P.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-10",
        "last_updated": "2012-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004983",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Decatur, GA

Sources for this page

Verify at the official NPI Registry.