DR. LISA RENEE HASTON-FULLER (NPI# 1831298397) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1831298397 |
| Entity Type | Individual |
| Full Name | DR. LISA RENEE HASTON-FULLER |
| Credential | DO |
| Practice Address |
9315 Telegraph Rd Redford MI 48239 |
| Mailing Address |
Po Box 401259 Redford MI 48240-9259 |
| Practice Telephone | 3134504500 |
| Practice Fax Number | 3134504514 |
| Mailing Telephone | 2485574999 |
| Enumeration Date | 2006-09-21 |
| Last Update Date | 2007-07-08 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2084P0800X |
Psychiatry & Neurology Specialization: Psychiatry |
5101011198 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | BH3040968 | 01 |
| Street Address |
9315 TELEGRAPH RD |
| City | REDFORD |
| State | MI |
| Zip Code | 48239 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669451944 | Lincoln Behavioral Services | General Practice | 9315 Telegraph Rd, Redford, MI 48239 | 2006-01-13 |
| 1356941454 | Angelica Debono | Social Worker | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2020-10-28 |
| 1477182574 | Christie Johnson | Social Worker | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2020-04-02 |
| 1043846116 | Breanne Johnson | Social Worker | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2020-03-20 |
| 1407488729 | Zeinab M Dabajeh | Social Worker | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2020-02-05 |
| 1356987762 | Lincoln Behavioral Services | Family Medicine | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2019-11-20 |
| 1952945826 | Daniel Evan Diskin | Social Worker | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2019-11-04 |
| 1124669775 | Sara Kifah Jayyousi | Peer Specialist | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2019-10-04 |
| 1275174062 | Kelsey Vest | Social Worker | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2019-10-02 |
| 1508415753 | Jennifer Pettway | Social Worker | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2019-09-10 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942849856 | Court'nee Ann Desmond | Nurse Practitioner | 14761 Telegraph Rd, Redford, MI 48239 | 2019-12-26 |
| 1891250239 | Sun Valley Pharmacy LLC | Pharmacy | 9291 Telegraph Rd, Redford, MI 48239 | 2019-02-08 |
| 1003343369 | Lucinda Pryor | Nurse Practitioner | 14210 Marion, Redford, MI 48239 | 2017-05-17 |
| 1740725274 | Georgetta W Bond | Technician, Other | 12770 Hemingway, Redford, MI 48239 | 2016-12-19 |
| 1508318015 | Doris Mckinney | Counselor | Lincoln Behavioral Services - 9315 Telegraph, Redford, MI 48239 | 2016-10-31 |
| 1609282110 | Rosaundra Tanika Pope | Home Health | 9989 Royal Grand, Redford, MI 48239 | 2014-07-03 |
| 1497170179 | Courtney Ritchie | General Practice | 24435 Plymouth Rd, Redford, MI 48239 | 2014-03-04 |
| 1003168592 | Alicia Monique Lurry | Counselor | 8171 Parkland, Detroit, MI 48239 | 2012-10-08 |
| 1407116080 | Ariss Tiffani Pierce | Physical Therapist | 14615 Telegraph Rd Ste 1, Redford, MI 48239 | 2012-05-17 |
| 1205144409 | Steven Thomas Haynes | Counselor | 7411 Parkland, Redford, MI 48239 | 2010-09-22 |
| Find all providers in zip 48239 | ||||
| Taxonomy Code | 2084P0800X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Psychiatry & Neurology |
| Specialization | Psychiatry |
| A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. |
| Notes: Source: The American Board of Psychiatry and Neurology, Inc. www.abpn.com [1/1/2007: new definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790955219 | Shabana Najmi Ahmed | Psychiatry & Neurology | 9315 Telegraph Road, Lincoln Behavioral Services, Redford, MI 48239 | 2008-03-12 |
| 1336284504 | Hyun Shin | Psychiatry & Neurology | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2007-02-21 |
| 1114086857 | Mohamed Siddique | Psychiatry & Neurology | 9315 Telegraph, Redford, MI 48239 | 2006-12-08 |
| 1225049125 | Sushila Aggarwal | Psychiatry & Neurology | 9315 Telegraph, Redford, MI 48239 | 2006-08-10 |
| 1396755658 | Rokeya Muhaimeen | Psychiatry & Neurology | 9315 Telegraph, Redford, MI 48239 | 2006-08-09 |
| 1770593766 | Abdul Hafeez | Psychiatry & Neurology | 9315 Telegraph, Redford, MI 48239 | 2006-08-09 |
| 1083624134 | Ismath Khan | Psychiatry & Neurology | 9315 Telegraph, Redford, MI 48239 | 2006-08-09 |
| 1740216134 | Prasad G Sripada | Psychiatry & Neurology | 9315 Telegraph Rd, Redford, MI 48239-1260 | 2006-06-25 |
| 1750327573 | Asha Jain | Psychiatry & Neurology | 9315 Telegraph Rd, Redford, MI 48239 | 2006-06-21 |
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|---|---|---|---|---|
| 1720686165 | Centia Health LLC | Psychiatry & Neurology | 23802 Wintergreen Cir, Novi, MI 48374-3681 | 2020-10-16 |
| 1114524428 | Clarity Behavioral Health Pllc | Psychiatry & Neurology | 7154 Merrybrook, West Bloomfield, MI 48322-4066 | 2020-10-08 |
| 1790395978 | Amiri Psychiatric Services Pllc | Psychiatry & Neurology | 1695 W Saratoga St, Ferndale, MI 48220-3153 | 2020-08-03 |
| 1881211191 | Infinite Wellness Healthcare, Pllc | Psychiatry & Neurology | 19855 Outer Dr Ste 504e, Dearborn, MI 48124-2040 | 2020-07-02 |
| 1528680303 | Emilia Elizabeth Mattioli | Psychiatry & Neurology | 965 Fee Road Room A223, East Lansing, MI 48824 | 2020-05-14 |
| 1447871983 | James O'brien | Psychiatry & Neurology | Msu Psychiatry Residency Program, 965 Fee Road, Room A233, East Lansing, MI 48824 | 2020-05-06 |
| 1083247134 | Actify Neurotherapies, Pllc | Psychiatry & Neurology | 28475 Greenfield Rd Ste 113, Southfield, MI 48076-3034 | 2020-02-18 |
| 1720611734 | Brightside Medical of Michigan, P.C. | Psychiatry & Neurology | Telemedicine Services Only / No Physical Office, Telemedicine Services Only / No Physical, MI 48170 | 2020-02-18 |
| 1922646538 | Sylvia Hanson Md Pllc | Psychiatry & Neurology | 6461 Golden Ln, West Bloomfield, MI 48322-3096 | 2019-12-13 |
| 1740823129 | Tms Wellness Clinic of Michigan Pllc | Psychiatry & Neurology | 5757 W Maple Rd Ste 800-b, West Bloomfield, MI 48322-2277 | 2019-10-18 |
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| 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.