Individual provider Active NPI

Lisa D Bausell, LPC, CEAP

  • Professional Counselor
  • Johnson City, TN
National Provider Identifier
1932400405
Registry record updated Feb 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
1471 Issued in TN
Practice address
701 Med Tech Pkwy Ste 201
Johnson City, TN 37604-2365
Phone
(423) 283-7302
NPI assigned
Nov 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 1471 TN Primary

Addresses

Primary practice location

701 Med Tech Pkwy Ste 201
Johnson City, TN 37604-2365

Mailing address

1021 W Oakland Ave Ste 310
Johnson City, TN 37604-2192
Phone (423) 302-6565

Other practice location 1

1241 Volunteer Pkwy Ste 436
Bristol, TN 37620-4635
Phone (423) 833-6419

Other practice location 2

525 N State Of Franklin Rd
Johnson City, TN 37604-8213
Phone (423) 302-3480

Other practice location 3

701 Med Tech Pkwy Ste 200
Johnson City, TN 37604-2371
Phone (423) 283-7302

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
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

Enrollment IDStateProvider typePAC IDDetails
I20240207002661 TN Practitioner - Mental Health Counselor 9436592300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 1997
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Wellmont Medical Associates IncGroup PAC ID 8123291739, 432 clinicians

Practice addresses (Care Compare)

111 W Stone Dr
Kingsport, TN 37660-6027

701 Med Tech Pkwy
Suite 200
Johnson City, TN 37604-2371
Phone (423) 302-3480

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1471TNMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Wellmont Medical Associates Inc CurrentSince Feb 5, 2024 Accepting new patients
Blue Ridge Medical Management Corporation Current Accepting new patients
Wellmont Medical Associates, Inc. CurrentSince Feb 5, 2024 Accepting new patients

Locations

701 Med Tech Pkwy
Ste 200
Johnson City, TN 37604
Phone (423) 283-7302

1021 W Oakland Ave
Ste 310
Johnson City, TN 37604
Phone (423) 302-6565

701 Med Tech Pkwy
Ste 201
Johnson City, TN 37604
Phone (423) 283-7302

111 W Stone Dr
Ste 100
Kingsport, TN 37660
Phone (423) 247-5197

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1289779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1708387200000",
    "number": "1932400405",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1021 W OAKLAND AVE STE 310",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042192",
            "telephone_number": "423-302-6565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "701 MED TECH PKWY STE 201",
            "city": "JOHNSON CITY",
            "state": "TN",
            "postal_code": "376042365",
            "telephone_number": "423-283-7302"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1241 Volunteer Pkwy Ste 436",
            "address_purpose": "LOCATION",
            "city": "Bristol",
            "state": "TN",
            "postal_code": "376204635",
            "country_code": "US",
            "telephone_number": "423-833-6419",
            "fax_number": "423-753-7656",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "525 N State Of Franklin Rd",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376048213",
            "country_code": "US",
            "telephone_number": "423-302-3480",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "701 Med Tech Pkwy Ste 200",
            "address_purpose": "LOCATION",
            "city": "Johnson City",
            "state": "TN",
            "postal_code": "376042371",
            "country_code": "US",
            "telephone_number": "423-283-7302",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BAUSELL",
        "first_name": "LISA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "LPC, CEAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-11-15",
        "last_updated": "2024-02-20",
        "certification_date": "2024-02-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "TN",
            "license": "1471",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Johnson City, TN

Sources for this page

Verify at the official NPI Registry.