Individual provider Active NPI

Lisa Mayo, LPC

  • Professional Counselor
  • Augusta, GA
National Provider Identifier
1720424054
Registry record updated May 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC006948 Issued in GA
Practice address
3643 Walton Way Ext
Augusta, GA 30909-4507
Phone
(706) 364-1404
Fax
(706) 364-1419
NPI assigned
May 14, 2013
Last updated
May 14, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 14, 2013

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 LPC006948 GA Primary

Addresses

Primary practice location

3643 Walton Way Ext
Augusta, GA 30909-4507

Mailing address

3643 Walton Way Ext
Augusta, GA 30909-4507
Phone (706) 364-1404

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20251024002334 GA Practitioner - Clinical Social Worker 5799273215 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1265 Interstate Pkwy
Suite B
Augusta, GA 30909

1265 Interstate Pkwy B
Augusta, GA 30909-6481

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LPC006948GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Inpatient Psychology Solutions LLC CurrentSince Oct 1, 2025 Accepting new patients

Locations

1265 Interstate Pkwy
#B
Augusta, GA 30909
Phone (706) 204-1366

3651 Wheeler Rd
Augusta, GA 30909
Phone (706) 651-2369

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": "1368489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368489600000",
    "number": "1720424054",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3643 WALTON WAY EXT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094507",
            "telephone_number": "706-364-1404",
            "fax_number": "706-364-1419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3643 WALTON WAY EXT",
            "city": "AUGUSTA",
            "state": "GA",
            "postal_code": "309094507",
            "telephone_number": "706-364-1404",
            "fax_number": "706-364-1419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAYO",
        "first_name": "LISA",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-05-14",
        "last_updated": "2013-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC006948",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Augusta, GA

Sources for this page

Verify at the official NPI Registry.