MISS LISA MARIE BOOMERS LLPC
NPI 1477900819
Counselor - Addiction (Substance Use Disorder) in Grand Rapids, MI

Active since May 16, 2016PECOS Enrolled
1215 FULTON ST E, GRAND RAPIDS, MI 49503(616) 742-0351 Get Directions Write a Review

NPPES record last updated: April 2, 2020. Verified against the NPPES registry weekly; last sync: August 16, 2026.

Record update history: Apr 2, 2020, May 30, 2019, May 16, 2016 (3 updates tracked since 2016).

About Miss Lisa Marie Boomers Llpc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MISS LISA MARIE BOOMERS LLPC (NPI 1477900819) is an individual addiction (substance use disorder) provider in Grand Rapids, Michigan, licensed in Michigan (6401017408) and active in the NPI registry since May 2016. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1477900819
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMISS LISA MARIE BOOMERSCredential: LLPC
Location Address1215 FULTON ST EGrand Rapids, MI 49503-3849
Mailing Address1800 W Main St Lot 56Lowell, MI 49331-1547 · (616) 901-0401
Sole ProprietorNo
Enumeration DateMay 16, 2016
Last NPPES UpdateApril 2, 20203 updates tracked since enumeration
NPPES CertifiedApril 2, 2020
NPI 1477900819 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License Licensed in MI · 6401017408
1215 FULTON ST E, Grand Rapids, MI 49503

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Miss Lisa Marie Boomers Llpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 14

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Family Medicine
1215 FULTON ST E
GRAND RAPIDS, MI 49503
Counselor (Addiction (Substance Use Disorder))
1215 FULTON ST E
GRAND RAPIDS, MI 49503
Licensed Practical Nurse
1215 FULTON ST E
GRAND RAPIDS, MI 49503
Social Worker (Clinical)
1215 FULTON ST E
GRAND RAPIDS, MI 49503
Substance Abuse Rehabilitation Facility
1215 FULTON ST E
GRAND RAPIDS, MI 49503
Registered Nurse
1215 FULTON ST E
GRAND RAPIDS, MI 49503
Licensed Practical Nurse
1215 FULTON ST E
GRAND RAPIDS, MI 49503
Counselor (Mental Health)
1215 FULTON ST E
GRAND RAPIDS, MI 49503

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Lisa Boomers's NPI number?

The NPI number for Lisa Boomers is 1477900819. It was assigned to this individual provider in the NPPES registry on May 16, 2016.

Where is Lisa Boomers located?

Lisa Boomers practices at 1215 Fulton St E, Grand Rapids, MI 49503. The listed phone number is (616) 742-0351.

What is Lisa Boomers's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Addiction (Substance Use Disorder), with taxonomy code 101YA0400X.

Is Lisa Boomers enrolled in Medicare?

Yes. Lisa Boomers is registered in the Medicare PECOS enrollment system.

What insurance does Lisa Boomers accept?

Health plans from Blue Care Network of Michigan, Blue Cross Blue Shield of Michigan Mutual Insurance Company, McLaren Health Plan Community, Oscar Insurance Company and Priority Health and 2 other insurers list Lisa Boomers as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lisa Boomers was last updated on April 2, 2020. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 6 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.