Individual provider Active NPI

Lisa Roberts, M.ED, LPCC

  • Mental Health Counselor
  • Lexington, KY
National Provider Identifier
1730510454
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
1599 Issued in KY
Practice address
3921 Gladman Way
Lexington, KY 40514-4028
Phone
(606) 307-8399
NPI assigned
Dec 5, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 1599 KY
Professional Counselor 101YP2500X 1599 KY
Mental Health Counselor 101YM0800X 1599 KY Primary

Addresses

Primary practice location

3921 Gladman Way
Lexington, KY 40514-4028

Mailing address

3921 Gladman Way
Lexington, KY 40514-4028
Phone (606) 307-8399

Other practice location 1

713 Millpond Rd
Lexington, KY 40514-1570
Phone (859) 888-0211

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)
Not enrolled
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
1599KYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Three Chairs Relational Counseling LLC Mental Health Current Accepting new patients
Brightside Medical, P.C. Past Accepting new patients

Organizations & group practices 2

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": "1386201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1730510454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 GLADMAN WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405144028",
            "telephone_number": "606-307-8399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 GLADMAN WAY",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405144028",
            "telephone_number": "606-307-8399"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "713 Millpond Rd",
            "address_purpose": "LOCATION",
            "city": "Lexington",
            "state": "KY",
            "postal_code": "405141570",
            "country_code": "US",
            "telephone_number": "859-888-0211",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "ROBERTS",
        "first_name": "LISA",
        "name_prefix": "Mrs.",
        "credential": "M.ED, LPCC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-12-05",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "KY",
            "license": "1599",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KY",
            "license": "1599",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "KY",
            "license": "1599",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.