MS. LISA J BLACK (NPI# 1508163015) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508163015 |
| Entity Type | Individual |
| Full Name | MS. LISA J BLACK |
| Credential | LPC |
| Practice Address |
205 E University Ave Ste 200 Georgetown TX 78626-6821 |
| Mailing Address |
5400 N Lamar Blvd Apt 3020 Austin TX 78751-5406 |
| Practice Telephone | 5126860207 |
| Practice Fax Number | 5124288060 |
| Mailing Telephone | 4096796522 |
| Enumeration Date | 2011-02-17 |
| Last Update Date | 2020-03-19 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 101Y00000X | Counselor | 64664 | TX | Behavioral Health & Social Service Providers |
| N | 101YM0800X |
Counselor Specialization: Mental Health |
64664 | TX | Behavioral Health & Social Service Providers |
| Y | 101YP2500X |
Counselor Specialization: Professional |
64664 | TX | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TX | 329506502 | 05 |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4450 Highland Ave, Houston, TX 77705 | 8325485000 | 7135234897 |
| 3560 Delaware St Ste 104, Beaumont, TX 777063059 | 4096796522 | 4098994606 |
| 775 Indian Trl Ste 200, Harker Heights, TX 765487026 | 5126860207 | 5124288060 |
| 4131 Spicewood Springs Rd Ste M2, Austin, TX 787598652 | 4096796522 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326396706 | Lisa Marie Black | Physical Therapy Assistant | 3433 Cranston Cir, Highlands Ranch, CO 80126-3620 | 2012-08-16 |
| 1780944520 | Lisa Anne Black | Nurse Practitioner | 220 S Courtenay Pkwy, Suite B, Merritt Island, FL 32952-4893 | 2012-05-28 |
| 1659631240 | Lisa Black | Physical Therapist | 11524 Spaulding St, Omaha, NE 68164-2366 | 2012-05-17 |
| 1497086219 | Lisa Lynn Black | Midwife | 3917 Hickory Bend Trl, Mckinney, TX 75071-2776 | 2010-01-18 |
| 1871780387 | Lisa Gail Black | Massage Therapist | 525 13th Avenue, Huntington, WV 25701 | 2007-09-28 |
| 1386787661 | Lisa Myers Black | Psychologist | 4003 24th Ave Ne, Norman, OK 73071-7749 | 2007-02-15 |
| 1851484307 | Lisa Breaux Black | Family Medicine | 895 Verret St, Houma, LA 70360-4635 | 2006-10-02 |
| 1730152653 | Lisa B Black | Internal Medicine | 701 E Marshall St Ste 640, West Chester, PA 19380-4412 | 2006-02-10 |
| 1922607696 | Lisa Black | Home Health Aide | 1119 S New York Ave, Wellston, OH 45692-2427 | 2020-10-22 |
| 1720582398 | Lisa Black | Occupational Therapist | 7445 Allen Rd Ste 102, Allen Park, MI 48101-1992 | 2018-03-20 |
| Street Address |
205 E UNIVERSITY AVE STE 200 |
| City | GEORGETOWN |
| State | TX |
| Zip Code | 78626-6821 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679560551 | John R Hudgins | Internal Medicine | 205 E University Ave Ste 200, Georgetown, TX 78626-6821 | 2005-10-05 |
| 1538670419 | Lone Star Circle of Care | Clinic/Center | 205 E University Ave Ste 200, Georgetown, TX 78626-6821 | 2017-10-18 |
| 1205122892 | Oralia Diaz | Registered Nurse | 205 E University Ave Ste 200, Georgetown, TX 78626-6821 | 2011-06-22 |
| 1801035472 | Donna Delbello | Social Worker | 205 E University Ave Ste 200, Georgetown, TX 78626-6821 | 2009-02-05 |
| 1477757037 | Tinku Davis | Pediatrics | 205 E University Ave Ste 200, Georgetown, TX 78626-6821 | 2007-06-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1932603230 | Danietra Mcgrue | Home Health Aide | 108 Blue Waterleaf Ln, Georgetown, TX 78626 | 2018-03-21 |
| 1588175673 | Kristin Marie Alaniz | Nurse Practitioner | 2112 Sw H K Dodgen Loop, Suite 110, Georgetown, TX 78626 | 2017-10-17 |
| 1669865275 | Stephen Harris | Counselor | 101 W Cooperative Way Ste 100, Georgetown, TX 78626 | 2015-03-07 |
| 1356739080 | Craig Crossman | Physical Therapy Assistant | 705 E 13th St, Georgetown, TX 78626 | 2015-01-05 |
| 1679977318 | Nancy Krenek | Physical Therapist | 2050 Rockride Ln., Georgetown, TX 78626 | 2014-10-09 |
| 1275956807 | Georgetown Behavioral Health Institute, LLC | Psychiatric Hospital | 3101 S. Austin Avenue, Georgetown, TX 78626 | 2014-02-03 |
| 1184056954 | Rock Springs, LLC | Psychiatric Hospital | 700 Southeast Inner Loop, Georgetown, TX 78626 | 2013-08-05 |
| 1447691936 | Brandon Michael Hoffman | Dentist | 1821 Westinghouse Road, Suite 1130, Georgetown, TX 78626 | 2013-07-11 |
| 1235422932 | Erica Marie Edgington | Nurse Anesthetist, Certified Registered | Westlake Anesthesia Group, Pa, 1004 South Rock Street, Georgetown, TX 78626 | 2011-05-27 |
| 1356570907 | Grace Salone | Optometrist | 950 W University Ave Ste 108, Georgetown, TX 78626 | 2009-07-03 |
| Find all providers in zip 78626 | ||||
| Taxonomy Code | 101YP2500X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Counselor |
| Specialization | Professional |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528668803 | Gwendolyn Marie Dicapo | Counselor | 207 S Elm St, Georgetown, TX 78626-5042 | 2020-10-27 |
| 1841813003 | The Shepherds New Pathways, LLC | Counselor | 3003 Dawn Dr Ste 101, Georgetown, TX 78628-2800 | 2020-05-22 |
| 1982225025 | Crystal L Force | Counselor | 1400 Westinghouse Rd Apt 416, Georgetown, TX 78626-2364 | 2020-04-29 |
| 1952933087 | Richard Johnston | Counselor | 407 W University Ave Ste 200, Georgetown, TX 78626-6710 | 2020-02-06 |
| 1033762711 | Rachel Saenger and Associates, LLC | Counselor | 3613 Williams Dr Ste 804, Georgetown, TX 78628-1374 | 2019-07-22 |
| 1770143695 | Christine Michelle Williams | Counselor | 3613 Williams Dr Ste 302, Georgetown, TX 78628-1369 | 2019-06-13 |
| 1316506546 | Danielle Terryl West | Counselor | 3613 Williams Dr Ste 1006, Georgetown, TX 78628-1376 | 2019-06-11 |
| 1538724174 | Alison R Winger | Counselor | 200 Bevins Ln Ste E, Georgetown, KY 40324-8532 | 2019-05-09 |
| 1487116810 | Rebecca Mcgee | Counselor | 3613 Williams Dr Ste 901, Georgetown, TX 78628-1375 | 2019-04-04 |
| 1235600438 | Emily Kaye Kipp-wright | Counselor | 106 E 16th St, Georgetown, TX 78626-6904 | 2018-12-16 |
| Find all providers in GEORGETOWN | ||||
| City | GEORGETOWN |
| Zip Code | 78626 |
Please comment or provide details below to improve the information on MS. LISA J BLACK.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.