MISS LISA MARIE BOOMERS LLPC
NPI 1477900819
Counselor - Addiction (Substance Use Disorder) in Grand Rapids, MI
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
Specialties & Licenses
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Miss Lisa Marie Boomers Llpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignment
Medicare enrollment records show Lisa Boomers reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.
Grand Rapids, MI 49506
- Reassigned Medicare billing, Michigan enrollment
- 287 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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.
GRAND RAPIDS, MI 49503
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.
Which organization bills Medicare for Lisa Boomers's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Boomers reassigns Medicare benefits to Counseling Center Of West Michigan, LLC (Grand Rapids, MI). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lisa Boomers's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Lisa Boomers accept?
Health plans from Ambetter Health, Ambetter from Buckeye Health Plan, Ambetter from Meridian, Blue Care Network of Michigan and Blue Cross Blue Shield of Michigan Mutual Insurance Company and 4 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.
# Miss Lisa Marie Boomers, LLPC · NPI 1477900819
Addiction (Substance Use Disorder) provider in Grand Rapids, Michigan. Individual provider, active in the CMS NPPES registry since May 16, 2016.
## Identity
- **NPI:** 1477900819 (Entity type: Individual)
- **Enumerated:** May 16, 2016
- **Primary specialty:** Counselor - Addiction (Substance Use Disorder) · taxonomy 101YA0400X
- **State license:** 6401017408 (Michigan)
- **Sole proprietor:** No
## Practice location
- **Address:** 1215 FULTON ST E, Grand Rapids, MI 49503-3849
- **Phone:** (616) 742-0351
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment
- **Bills Medicare through:** Counseling Center Of West Michigan, LLC (NPI 1437610730, Grand Rapids, MI), under Medicare reassignment (form CMS-855R) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 2, 2020
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Source: [NPI Profile](https://npiprofile.com/npi/1477900819) · Data from the CMS NPPES public registry.