Individual provider Active NPI

Lisa Balk

  • Mental Health Counselor
  • Davenport, IA
National Provider Identifier
1861817462
Registry record updated Aug 22, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
001586 Issued in IA
Practice address
1140 E Kimberly Rd Unit 1B
Davenport, IA 52807-1748
Phone
(563) 200-3154
Fax
(833) 228-5356
NPI assigned
Feb 19, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 22, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 001586 IA Primary

Addresses

Primary practice location

1140 E Kimberly Rd Unit 1B
Davenport, IA 52807-1748

Mailing address

1140 E Kimberly Rd Ste 110
Davenport, IA 52807-1748
Phone (563) 200-3154

Other practice location 1

1202 W 3rd St
Davenport, IA 52802-1344
Phone (563) 324-9169

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
001586IAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Hope for Tomorrow Therapy Services, LLC CurrentSince Sep 5, 2023 Accepting new patients

Locations

1140 E Kimberly Rd
Ste 110
Davenport, IA 52807
Phone (563) 200-3154

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": "1392768000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692662400000",
    "number": "1861817462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1140 E KIMBERLY RD STE 110",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071748",
            "telephone_number": "563-200-3154",
            "fax_number": "833-228-5356"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1140 E KIMBERLY RD UNIT 1B",
            "city": "DAVENPORT",
            "state": "IA",
            "postal_code": "528071748",
            "telephone_number": "563-200-3154",
            "fax_number": "833-228-5356"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1202 W 3rd St",
            "address_purpose": "LOCATION",
            "city": "Davenport",
            "state": "IA",
            "postal_code": "528021344",
            "country_code": "US",
            "telephone_number": "563-324-9169",
            "fax_number": "563-324-2437",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BALK",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-02-19",
        "last_updated": "2023-08-22",
        "certification_date": "2023-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "001586",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2023; 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.