Dr Lisa E-Therapy

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

Legal business name

DR LISA E-THERAPY

Practice address

3539 Douglas Dr N
Minneapolis, MN 55422-2415

Phone

(612) 642-1355

Fax

(612) 756-7059

NPI assigned

Dec 6, 2019

Organization subpart

No

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

Authorized official

Name

Dr. Lisa Eileen Lovelace, PSYD

Title

Owner, Clinical Psychology

Phone

(612) 642-1355

Specialties & licenses 6

Addresses

Other names 1

• Synergy eTherapy Doing business as

Medicare fee-for-service enrollment

Enrolled in MN

Enrollment records 1

Locations

Practitioners 8

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

• Jean Storlie, LPCC

  • Professional Counselor
  • Minneapolis, MN
  • NPI 1386048221
  Medicare reassignment NPD
• Porshia Burrows

  • Mental Health Counselor
  • Minneapolis, MN
  • NPI 1205652708
  NPD
• Jessica Lewis, BS

  • Marriage & Family Therapist
  • Minneapolis, MN
  • NPI 1972493054
  NPD
• Percy Smith

  • Student in an Organized Health Care Education/Training Program
  • Minneapolis, MN
  • NPI 1497647655
  NPD
• Emma Rae Haase

  • Mental Health Counselor
  • Springfield, OR
  • NPI 1710779822
  NPD
• Courtney Renee Setzer

  • Mental Health Counselor
  • Effingham, SC
  • NPI 1376336784
  NPD
• Barbara Wormington

  • Mental Health Counselor
  • Maple Grove, MN
  • NPI 1043074131
  NPD (past)
• Li Ting Lin, PHD

  • Psychologist
  • Glastonbury, CT
  • NPI 1750199287
  NPD (past)

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

{
    "created_epoch": "1575590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635897600000",
    "number": "1770120933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3539 DOUGLAS DR N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554222415",
            "telephone_number": "612-642-1355",
            "fax_number": "612-756-7059"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3539 DOUGLAS DR N",
            "city": "MINNEAPOLIS",
            "state": "MN",
            "postal_code": "554222415",
            "telephone_number": "612-642-1355",
            "fax_number": "612-756-7059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR LISA E-THERAPY",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-12-06",
        "last_updated": "2021-11-03",
        "certification_date": "2021-11-03",
        "status": "A",
        "authorized_official_last_name": "LOVELACE",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "EILEEN",
        "authorized_official_title_or_position": "OWNER, CLINICAL PSYCHOLOGY",
        "authorized_official_telephone_number": "612-642-1355",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Marriage & Family Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "364SP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Synergy eTherapy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Synergy eTherapy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Clinical Psychologist in Minneapolis, MN
• Providers in Minneapolis, MN by specialty
• Clinical Psychologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 3, 2021; 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.