Lisa Marie Wooley, PSYD, HSPP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

20041473A Issued in IN

Practice address

2860 Northpark Ave
Huntington, IN 46750-9700

Phone

(260) 356-2875

Fax

(260) 358-0611

NPI assigned

Oct 27, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in IN

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

Specialty

Clinical Psychologist

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Live Heal Grow Counseling ServicesGroup PAC ID 0547665325, 18 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Blue River Counseling LLC

  • Psychologist
  • Huntington, IN
  • NPI 1669342697
  Medicare reassignment NPD Authorized official
• Live Heal Grow Counseling Services

  • Mental Health Counselor
  • Columbia City, IN
  • NPI 1780274712

  Clinical

  Medicare reassignment Care Compare group NPD
• Bowen Health Inc

  • Adult Mental Health Clinic/Center
  • Warsaw, IN
  • NPI 1639172810
  Medicare reassignment NPD
• Bowen Health Inc

  • Federally Qualified Health Center (FQHC)
  • Fort Wayne, IN
  • NPI 1023668183
  NPD

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

{
    "created_epoch": "1130371200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292803200000",
    "number": "1891785192",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850 N HARRISON ST",
            "city": "WARSAW",
            "state": "IN",
            "postal_code": "465803163",
            "telephone_number": "574-267-7169",
            "fax_number": "574-268-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2860 NORTHPARK AVE",
            "city": "HUNTINGTON",
            "state": "IN",
            "postal_code": "467509700",
            "telephone_number": "260-356-2875",
            "fax_number": "260-358-0611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOOLEY",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "PSYD, HSPP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-27",
        "last_updated": "2010-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "IN",
            "license": "20041473A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200235550A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Deah K Wolf, PHARMD
• Kellie Woll, MA
• Justin Christopher Wolpert
• Womens Health Care
• Womens Medical Specialists
• Steven G. Wynder, MD
• Anne Yaple, PT
• Rowena C Yu-Mendador, MD

• Clinical Psychologist in Huntington, IN
• Providers in Huntington, IN by specialty
• Clinical Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2010; 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.

Verify at the official NPI Registry.