Individual provider Active NPI

Heeseong Lee Ha, LCPC, LCAC

  • Professional Counselor
  • Overland Park, KS
National Provider Identifier
1760860324
Registry record updated Oct 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
03606 Issued in KS
Practice address
7180 W 107TH St Ste 5
Overland Park, KS 66212-2523
Phone
(913) 346-6006
NPI assigned
May 14, 2015
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 00751 KS
Professional Counselor 101YP2500X 03606 KS Primary

Addresses

Primary practice location

7180 W 107TH St Ste 5
Overland Park, KS 66212-2523

Mailing address

3812 W 155TH St
Overland Park, KS 66224-3989
Phone (913) 271-5172

Other practice location 1

3812 W 155th St
Overland Park, KS 66224-3989
Phone (913) 346-6006

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20240301003621 KS Practitioner - Mental Health Counselor 6103261946 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
00751KSMDAddiction (Substance Use Disorder) Counselor
03606KSMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Brightside Medical, P.a. CurrentSince Feb 25, 2024 Accepting new patients

Locations

2261 Market St
San Francisco, CA 94114
Phone (213) 337-4615

4925 S Broadway Ave
Wichita, KS 67216
Phone (316) 227-1989

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1431561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727827200000",
    "number": "1760860324",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3812 W 155TH ST",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662243989",
            "telephone_number": "913-271-5172"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7180 W 107TH ST STE 5",
            "city": "OVERLAND PARK",
            "state": "KS",
            "postal_code": "662122523",
            "telephone_number": "913-346-6006"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3812 W 155th St",
            "address_purpose": "LOCATION",
            "city": "Overland Park",
            "state": "KS",
            "postal_code": "662243989",
            "country_code": "US",
            "telephone_number": "913-346-6006",
            "fax_number": "913-538-0266",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HA",
        "first_name": "HEESEONG",
        "middle_name": "LEE",
        "name_prefix": "Mrs.",
        "credential": "LCPC, LCAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-05-14",
        "last_updated": "2024-10-02",
        "certification_date": "2024-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "KS",
            "license": "00751",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "KS",
            "license": "03606",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Overland Park, KS

Sources for this page

Verify at the official NPI Registry.