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LISA BLALOCK LMHC
NPI 1639661960
Counselor - Mental Health in Webster, NY

Active since June 01, 2018
807 RIDGE RD STE 206, WEBSTER, NY 14580(585) 738-9076 Get Directions Write a Review

NPPES record last updated: June 1, 2018. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Lisa Blalock Lmhc NPPES

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

LISA BLALOCK LMHC (NPI 1639661960) is an individual mental health provider in Webster, New York, licensed in New York (008660) and active in the NPI registry since June 2018.

NPPES Registry Identity

NPI1639661960
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameLISA BLALOCKCredential: LMHC
Location Address807 RIDGE RD STE 206Webster, NY 14580-2497
Mailing Address411 Parsons AcresOntario, NY 14519-9323 · (585) 738-9076
Phone(585) 738-9076
Sole ProprietorYes
Enumeration DateJune 1, 2018
✔ NPI 1639661960 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 008660
807 RIDGE RD STE 206, Webster, NY 14580
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Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Lisa Blalock Lmhc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from January 1, 2024 through January 1, 2026.

Opt-Out Effective DateJanuary 1, 2024
Opt-Out In Effect ThroughJanuary 1, 2026Opt-out affidavits renew automatically every two years unless cancelled

Frequently Asked Questions

What is Lisa Blalock's NPI number?

The NPI number assigned to this healthcare provider is 1639661960, enumerated as an "individual" on June 01, 2018.

Where is the provider located?

The provider is located at 807 RIDGE RD STE 206 WEBSTER, NY 14580 and the phone number is (585) 738-9076.

What is the provider's specialty?

Counselor with taxonomy code 101YM0800X and a focus in Mental Health.