Lisa Rivka Minor, PH.D, HSPP, BCBA-D

Primary specialty

PsychologistTaxonomy code 103T00000X

License

20042808A Issued in IN

Practice address

1061 E Southern Avenue
Diagnostic Office
Indianapolis, IN 46203

Phone

(317) 207-1986

NPI assigned

Jul 9, 2013

Last updated

Nov 8, 2024By the provider in NPPES

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

Other names 1

• Lisa Rivka Libster Professional name

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• The Hope Source Inc.

  • Multi-Specialty Clinic/Center
  • Indianapolis, IN
  • NPI 1265736615

  Behavior Analyst

  Medicare reassignment NPD
• Autism Companion Services

  • Behavior Analyst
  • Carmel, IN
  • NPI 1316561087
  NPD (past)
• Autism Spectrum Therapies, LLC

  • Behavior Analyst
  • Burbank, CA
  • NPI 1609194000
  NPD (past)

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

{
    "created_epoch": "1373328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731024000000",
    "number": "1912348764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "614 E 52ND ST",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462051156",
            "telephone_number": "410-440-5381"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1061 E SOUTHERN AVENUE",
            "address_2": "DIAGNOSTIC OFFICE",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "46203",
            "telephone_number": "317-207-1986"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7739 E 88th St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462561231",
            "country_code": "US",
            "telephone_number": "317-578-0410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "9929 E 126th St",
            "address_purpose": "LOCATION",
            "city": "Fishers",
            "state": "IN",
            "postal_code": "460389404",
            "country_code": "US",
            "telephone_number": "317-436-8961",
            "fax_number": "317-436-8966",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8350 Craig St",
            "address_purpose": "LOCATION",
            "city": "Indianapolis",
            "state": "IN",
            "postal_code": "462503593",
            "country_code": "US",
            "telephone_number": "317-578-0410",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MINOR",
        "first_name": "LISA",
        "middle_name": "RIVKA",
        "credential": "PH.D, HSPP, BCBA-D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-09",
        "last_updated": "2024-11-08",
        "certification_date": "2024-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "IN",
            "license": "20042808A",
            "primary": true
        },
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": "11212660",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LISA",
            "last_name": "LIBSTER",
            "middle_name": "RIVKA",
            "credential": "PH.D, HSPP, BCBA-D",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Minor Step to Major Healing
• Antionette S. Minor, PSA
• Cheveria Minor, MSW
• James R Minor, MD
• Joy Elisha Minor, MA
• Norman Earl Minor Jr., LCSW
• Minority Mental Health Initiative LLC
• Noha F. Minshawi-Patterson, PH.D.
• Diana Rachel Minton, RN, BSN
• Katherine Grace Minton

• Psychologist in Indianapolis, IN
• Providers in Indianapolis, IN by specialty
• Psychologist in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.