NPIMap

Organization Active NPI

Lisa H. Kornberg, LLC

  • Mental Health Counselor
  • Baltimore, MD
National Provider Identifier
1811762891
Registry record updated Nov 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
LISA H. KORNBERG, LLC
Practice address
5901 Falls Rd
Baltimore, MD 21209-3725
Phone
(113) 590-3701
Fax
(844) 917-2824
NPI assigned
Nov 20, 2023
Last updated
Nov 20, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2023

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

Authorized official

Name
Lisa Harriet Kornberg, LCPCNPI 1477564805
Title
Psychotherapist
Phone
(443) 590-3701

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

5901 Falls Rd
Baltimore, MD 21209-3725

Mailing address

5901 Falls Rd
Baltimore, MD 21209-3725
Phone (443) 590-3701

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MD

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231205002551 MD Part B Supplier - Clinic/Group Practice 7315396116 Receives reassigned benefits from 1 practitioner
Practice locations: Baltimore, MD

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1700438400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1700438400000",
    "number": "1811762891",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5901 FALLS RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093725",
            "telephone_number": "443-590-3701",
            "fax_number": "844-917-2824"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5901 FALLS RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212093725",
            "telephone_number": "113-590-3701",
            "fax_number": "844-917-2824"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LISA H. KORNBERG, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-11-20",
        "last_updated": "2023-11-20",
        "certification_date": "2023-11-20",
        "status": "A",
        "authorized_official_last_name": "KORNBERG",
        "authorized_official_first_name": "LISA",
        "authorized_official_middle_name": "HARRIET",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "443-590-3701",
        "authorized_official_credential": "LCPC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Baltimore, MD

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2023; 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.