Active NPI
Lisa Ferrara Summers, MFT
- Mental Health Counselor
- San Carlos, CA
National Provider Identifier
1902431026
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 105627
- Practice address
- 1139 San Carlos Ave Ste 310
San Carlos, CA 94070-2450 - Phone
- (650) 521-9919
- NPI assigned
- Mar 9, 2020
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 105627 | CA | Primary |
Addresses
Primary practice location
1139 San Carlos Ave Ste 310
San Carlos, CA 94070-2450
Mailing address
2005 Seabrook CT
Redwood City, CA 94065-8478
Phone (650) 218-6130
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Feb 10, 2024 through Feb 10, 2028
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105627 | CA | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1583712000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1583712000000",
"number": "1902431026",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2005 SEABROOK CT",
"city": "REDWOOD CITY",
"state": "CA",
"postal_code": "940658478",
"telephone_number": "650-218-6130"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1139 SAN CARLOS AVE STE 310",
"city": "SAN CARLOS",
"state": "CA",
"postal_code": "940702450",
"telephone_number": "650-521-9919"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUMMERS",
"first_name": "LISA",
"middle_name": "FERRARA",
"name_prefix": "Ms.",
"credential": "MFT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-03-09",
"last_updated": "2020-03-09",
"certification_date": "2020-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "CA",
"license": "105627",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in San Carlos, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.