Individual provider Active NPI

Lisa Lenere Adams, LCMHCS, LCAS

  • Professional Counselor
  • Charlotte, NC
National Provider Identifier
1811154693
Registry record updated Sep 22, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
4933 Issued in NC
Practice address
10130 Mallard Creek Rd Ste 300
Charlotte, NC 28262-6001
Phone
(336) 937-0331
Fax
(877) 595-1857
NPI assigned
May 20, 2008
Sex
Female
Sole proprietor
Yes

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

State licenses

LicenseStateTypeSpecialty
4933NCMDProfessional Counselor

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 4933 NC Primary

Addresses

NPPES NPI Registry

Primary practice location

10130 Mallard Creek Rd Ste 300
Charlotte, NC 28262-6001

Mailing address

10130 Mallard Creek Rd Ste 300
Charlotte, NC 28262-6001
Phone (336) 937-0331

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
6104366MedicaidNC

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Sep 22, 2022.

{
    "created_epoch": "1211241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663804800000",
    "number": "1811154693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10130 MALLARD CREEK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282626001",
            "telephone_number": "336-937-0331",
            "fax_number": "877-595-1857"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10130 MALLARD CREEK RD STE 300",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282626001",
            "telephone_number": "336-937-0331",
            "fax_number": "877-595-1857"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ADAMS",
        "first_name": "LISA",
        "middle_name": "LENERE",
        "name_prefix": "Mrs.",
        "credential": "LCMHCS, LCAS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-05-20",
        "last_updated": "2022-09-22",
        "certification_date": "2022-09-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NC",
            "license": "4933",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6104366",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charlotte, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 22, 2022; 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.