Individual provider Active NPI

Lisa Ann Langstraat, LPC

  • Mental Health Counselor
  • Milwaukie, OR
National Provider Identifier
1982957049
Registry record updated Apr 14, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
C2946 Issued in OR
Practice address
11630 SE 40TH Ave Ste a
Milwaukie, OR 97222-6195
Phone
(503) 919-1743
NPI assigned
Oct 25, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 14, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X C2946 OR Primary
Professional Counselor 101YP2500X C2946 OR

Addresses

Primary practice location

11630 SE 40TH Ave Ste a
Milwaukie, OR 97222-6195

Mailing address

634 E 13TH PL
Lafayette, OR 97127-9217
Phone (503) 919-1743

Other practice location 1

16115 SE Harold Ave
Milwaukie, OR 97267-3953
Phone (503) 919-1743

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 16, 2024 through Feb 16, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
C2946ORMDProfessional Counselor

NPI Registry JSON

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

{
    "created_epoch": "1351123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1555200000000",
    "number": "1982957049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "634 E 13TH PL",
            "city": "LAFAYETTE",
            "state": "OR",
            "postal_code": "971279217",
            "telephone_number": "503-919-1743"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11630 SE 40TH AVE STE A",
            "city": "MILWAUKIE",
            "state": "OR",
            "postal_code": "972226195",
            "telephone_number": "503-919-1743"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16115 SE Harold Ave",
            "address_purpose": "LOCATION",
            "city": "Milwaukie",
            "state": "OR",
            "postal_code": "972673953",
            "country_code": "US",
            "telephone_number": "503-919-1743",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LANGSTRAAT",
        "first_name": "LISA",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-10-25",
        "last_updated": "2019-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "OR",
            "license": "C2946",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "OR",
            "license": "C2946",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukie, OR

Sources for this page

Verify at the official NPI Registry.