Individual provider Active NPI

Lisa Marie Johanns, LPC

  • Professional Counselor
  • Enfield, CT
National Provider Identifier
1962631663
Registry record updated Nov 6, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
002077 Issued in CT
Practice address
153 Hazard Ave
Enfield, CT 06082-4592
Phone
(860) 250-5020
Fax
(860) 250-5030
NPI assigned
Jul 2, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2013

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 002077 CT Primary

Addresses

Primary practice location

153 Hazard Ave
Enfield, CT 06082-4592

Mailing address

153 Hazard Ave
Enfield, CT 06082-4592
Phone (860) 250-5020

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CT
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
I20241002002956 CT Practitioner - Mental Health Counselor 2466800255 Receives reassigned benefits from 1 practitioner
Practice locations: South Windsor, CT

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

435 Buckland Rd
South Windsor, CT 06074-3720

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
002077CTMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Thrive and Grow Psychotherapy Professional Current Accepting new patients

Locations

2389 Main St
Ste 100
Glastonbury, CT 06033
Phone (203) 521-6560

435 Buckland Rd
South Windsor, CT 06074
Phone (860) 249-3272

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Organizations & group practices 1

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": "1246492800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383696000000",
    "number": "1962631663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "153 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824592",
            "telephone_number": "860-250-5020",
            "fax_number": "860-250-5030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "153 HAZARD AVE",
            "city": "ENFIELD",
            "state": "CT",
            "postal_code": "060824592",
            "telephone_number": "860-250-5020",
            "fax_number": "860-250-5030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JOHANNS",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-07-02",
        "last_updated": "2013-11-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "CT",
            "license": "002077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enfield, CT

Sources for this page

Verify at the official NPI Registry.