Lisa Jane Backus, PSYD

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

003187 Issued in CT

Practice address

129 Tolland Stage Rd
Suite 1
Tolland, CT 06084-2342

Phone

(860) 454-0611

Fax

(860) 454-0919

NPI assigned

Nov 15, 2012

Last updated

Oct 3, 2014By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Specialty

Clinical Psychologist

Education

Other, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Horizon Counseling Services LLC

  • Community/Behavioral Health Agency
  • Ellington, CT
  • NPI 1790122885
  NPD Authorized official

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

{
    "created_epoch": "1352937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412294400000",
    "number": "1770827677",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 537",
            "city": "WILLINGTON",
            "state": "CT",
            "postal_code": "062790537",
            "telephone_number": "860-837-4995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 TOLLAND STAGE RD",
            "address_2": "SUITE 1",
            "city": "TOLLAND",
            "state": "CT",
            "postal_code": "060842342",
            "telephone_number": "860-454-0611",
            "fax_number": "860-454-0919"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BACKUS",
        "first_name": "LISA",
        "middle_name": "JANE",
        "name_prefix": "Dr.",
        "credential": "PSYD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-11-15",
        "last_updated": "2014-10-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CT",
            "license": "003187",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Allen, FNP
• Diane Packard Annibalini, PA-C
• Sue Armstrong, LMT,CMLDT
• Nancy Arnold, LPC
• Sarah Assenso-Bediako, RN
• Laura Badecker, LMFT
• Victoria Baker
• Andrea S Barletta, APRN
• Jennifer Bartson, CPNP-PC
• Gerald M Bayona, MD

• Clinical Psychologist in Tolland, CT
• Providers in Tolland, CT by specialty
• Clinical Psychologist in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 3, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.