Lisa A Faires, M.ED. LCPC,LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MH 13040 Issued in FL

Practice address

1380 Phyllis Dr
Merritt Island, FL 32952-5841

Phone

(207) 233-1350

NPI assigned

Nov 10, 2009

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Education

State licenses

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

{
    "created_epoch": "1257811200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424995200000",
    "number": "1891022919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 PHYLLIS DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329525841",
            "telephone_number": "207-233-1350"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 PHYLLIS DR",
            "city": "MERRITT ISLAND",
            "state": "FL",
            "postal_code": "329525841",
            "telephone_number": "207-233-1350"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAIRES",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "M.ED. LCPC,LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-10",
        "last_updated": "2015-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "ME",
            "license": "CC3775",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH 13040",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rowena Calanday Esmino-Green
• Essence of Chanel Hair and Beauty LLC
• William Erhard Eyring III, PSYD
• Skyhawk Fadigan, MD
• Susan Carole Fair, DO
• Family Medical Care of Brevard
• Farrington House LLC
• Ashley Nicole Faulkner, DNP, APRN, FNP-C
• Snyder Faustin, BCABA
• Justin Fegers

• Mental Health Counselor in Merritt Island, FL
• Providers in Merritt Island, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2015; 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.