NPIMap

Individual provider Active NPI

Donna Kay Thompson-Lisiecki, LPC

  • Professional Counselor
  • Folkston, GA
National Provider Identifier
1871708057
Registry record updated Dec 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC004677 Issued in GA
Practice address
710 Bowery LN
BLDG. G Box 41
Folkston, GA 31537-5967
Phone
(912) 496-2616
Fax
(912) 496-2671
NPI assigned
May 11, 2007
Last updated
Dec 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC004677 GA Primary

Addresses

Primary practice location

710 Bowery LN
BLDG. G Box 41
Folkston, GA 31537-5967

Mailing address

710 Bowery LN
BLDG. G Box 41
Folkston, GA 31537-5967
Phone (912) 617-0008

Other identifiers 1

IdentifierTypeStateIssuer
20-8008619OtherGAFEDERAL EMPLOYER ID #

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
LPC004677GAMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
L.I.F.E. Counseling Services Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1178841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418169600000",
    "number": "1871708057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "710 BOWERY LN",
            "address_2": "BLDG. G BOX 41",
            "city": "FOLKSTON",
            "state": "GA",
            "postal_code": "315375967",
            "telephone_number": "912-617-0008",
            "fax_number": "912-496-2671"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "710 BOWERY LN",
            "address_2": "BLDG. G BOX 41",
            "city": "FOLKSTON",
            "state": "GA",
            "postal_code": "315375967",
            "telephone_number": "912-496-2616",
            "fax_number": "912-496-2671"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON-LISIECKI",
        "first_name": "DONNA",
        "middle_name": "KAY",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-11",
        "last_updated": "2014-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC004677",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FEDERAL EMPLOYER ID #",
            "identifier": "20-8008619",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Folkston, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2014; 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.