Active NPI
Lisa Diane Wilson, PSY.D.
- Clinical Psychologist
- Olathe, KS
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- LP03197
- Practice address
- 21350 W 153Rd St
Olathe, KS 66061-5413 - Phone
- (913) 322-2400
- Fax
- (913) 621-5730
- NPI assigned
- Dec 26, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Child & Adolescent Psychologist | 103TC2200X | T-LP1703 | KS | |
| Clinical Psychologist | 103TC0700X | LP03197 | KS | Primary |
Addresses
Primary practice location
21350 W 153Rd St
Olathe, KS 66061-5413
Mailing address
11642 Garnett St
Overland Park, KS 66210-3435
Phone (913) 370-6541
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KS
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
7101 E 21St St N
Wichita, KS 67206-1044
Phone (888) 365-6271
8900 Parallel Pkwy
Kansas City, KS 66112-1637
Phone (888) 365-6271
9100 Park St
Lenexa, KS 66215-3353
Phone (888) 365-6271
Merit-based Incentive Payment System (MIPS)
- Final score
- 91.16 of 100
- Quality
- 80.99
- Improvement activities
- 40
- Cost
- 72.05
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LP03197 | KS | MD | Clinical Psychologist |
| T-LP1703 | KS | MD | Clinical Child & Adolescent Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Deer Oaks Mental Health Associates PC | Clinical | Current | Accepting new patients |
Locations
7101 E 21st St N
Wichita, KS 67206
Phone (316) 682-8909
7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472
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": "1198627200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1674000000000",
"number": "1881878916",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11642 GARNETT ST",
"city": "OVERLAND PARK",
"state": "KS",
"postal_code": "662103435",
"telephone_number": "913-370-6541"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "21350 W 153RD ST",
"city": "OLATHE",
"state": "KS",
"postal_code": "660615413",
"telephone_number": "913-322-2400",
"fax_number": "913-621-5730"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WILSON",
"first_name": "LISA",
"middle_name": "DIANE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-12-26",
"last_updated": "2023-01-18",
"certification_date": "2023-01-18",
"status": "A"
},
"taxonomies": [
{
"code": "103TC2200X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical Child & Adolescent",
"state": "KS",
"license": "T-LP1703",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "KS",
"license": "LP03197",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Olathe, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.