Individual provider Active NPI

Lisa D Carpenter, LMFT

  • Marriage & Family Therapist
  • Clemmons, NC
National Provider Identifier
1881300069
Registry record updated Oct 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
12489A Issued in NC
Practice address
3540 Clemmons Rd Ste 138
Clemmons, NC 27012-8100
Phone
(336) 701-5999
NPI assigned
Jan 30, 2023
Last updated
Oct 26, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 12489A NC Primary

Addresses

Primary practice location

3540 Clemmons Rd Ste 138
Clemmons, NC 27012-8100

Mailing address

239 Peppermill Dr
Lexington, NC 27295-5993
Phone (602) 541-4042

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250915000560 NC Practitioner - Marriage and Family Therapist 9638672678 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Marriage and Family Therapist
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

239 Peppermill Dr
Lexington, NC 27295-5993

3305 Healy Dr
Winston Salem, NC 27103-1406

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12489ANCMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Banyan Tree Counseling PLLC CurrentSince Aug 1, 2025 Accepting new patients

Locations

1365 Westgate Center Dr
Ste L1
Winston Salem, NC 27103
Phone (336) 448-4451

3305 Healy Dr
Winston Salem, NC 27103
Phone (336) 448-4451

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, 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": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761436800000",
    "number": "1881300069",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "239 PEPPERMILL DR",
            "city": "LEXINGTON",
            "state": "NC",
            "postal_code": "272955993",
            "telephone_number": "602-541-4042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 CLEMMONS RD STE 138",
            "city": "CLEMMONS",
            "state": "NC",
            "postal_code": "270128100",
            "telephone_number": "336-701-5999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARPENTER",
        "first_name": "LISA",
        "middle_name": "D",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2025-10-26",
        "certification_date": "2025-10-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "NC",
            "license": "12489A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clemmons, NC

Sources for this page

Verify at the official NPI Registry.