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LISA BLACKWELL
NPI 1659974756
Counselor - Professional in Canton, OH

Active since November 19, 2020PECOS Enrolled
4105 FULTON DR NW, CANTON, OH 44718(216) 438-0790 Get Directions Write a Review

NPPES record last updated: September 8, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 8, 2026, Oct 2, 2023, Aug 9, 2023 and 1 more (4 updates tracked since 2020).

About Lisa Blackwell NPPES

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

LISA BLACKWELL (NPI 1659974756) is an individual professional provider in Canton, Ohio, licensed in Ohio (E.2303356) and active in the NPI registry since November 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1659974756
Entity TypeIndividualFemale
Primary Taxonomy101YP2500X
Provider Legal NameLISA BLACKWELL
Location Address4105 FULTON DR NWCanton, OH 44718-2819
Mailing Address4105 Fulton Dr NwCanton, OH 44718-2819 · (216) 438-0790
Phone(216) 438-0790
Sole ProprietorYes
Enumeration DateNovember 19, 2020
Last NPPES UpdateSeptember 8, 20264 updates tracked since enumeration
NPPES CertifiedSeptember 8, 2026
✔ NPI 1659974756 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · ProfessionalBehavioral Health & Social Service Providers
Taxonomy Code101YP2500X
License✔ Licensed in OH · E.2303356
4105 FULTON DR NW, Canton, OH 44718
Open in Google Maps ↗

Other Names 1

Former Name (1)Lisa Kaser

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, CareSource, MedMutual and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Lisa Blackwell 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.

Medicare Billing Reassignments

2

Medicare enrollment records show Lisa Blackwell reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Avo Behavioral Health LLC
0.3 mi
Adult Mental Health
4433 38TH ST NW
Canton, OH 44718
  • Reassigned Medicare billing, Ohio enrollment
  • 9 clinicians in this Medicare group
NPI 1104431410 (330) 331-7506
Grow Healthcare Group PA
1,041 mi
Mental Health
66 W FLAGLER ST STE 900
Miami, FL 33130
  • Reassigned Medicare billing, Ohio enrollment
  • 725 clinicians in this Medicare group
NPI 1245845932 (786) 244-7711

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 5

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

JODIE LYNN MOSES LMT
Massage Therapist
4105 FULTON DR NW
CANTON, OH 44718
Stark County (234) 322-6516
MARY LYNNE PIZZOLA LMT, CNMT
Massage Therapist
4105 FULTON DR NW
CANTON, OH 44718
Stark County (330) 492-6655
MRS. ANGEL WEBSTER LMT
Massage Therapist
4105 FULTON DR NW
CANTON, OH 44718
Stark County (330) 961-1365
VITALITY PHYSICAL THERAPY LLC
Physical Therapist
4105 FULTON DR NW
CANTON, OH 44718
Stark County (330) 203-1078
ROBERT L SPAULDING CNMT, LMT
Massage Therapist
4105 FULTON DR NW
CANTON, OH 44718
Stark County (330) 492-6655

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 Blackwell's NPI number?

The NPI number for Lisa Blackwell is 1659974756. It was assigned to this individual provider in the NPPES registry on November 19, 2020. The provider is also known as Lisa Kaser.

Where is Lisa Blackwell located?

Lisa Blackwell practices at 4105 Fulton Dr NW, Canton, OH 44718. The listed phone number is (216) 438-0790.

What is Lisa Blackwell's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Professional, with taxonomy code 101YP2500X.

Is Lisa Blackwell enrolled in Medicare?

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

Which organizations bill Medicare for Lisa Blackwell's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lisa Blackwell reassigns Medicare benefits to 2 organizations: Avo Behavioral Health LLC (Canton, OH) and Grow Healthcare Group PA (Miami, FL). Each 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 Blackwell's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lisa Blackwell accept?

Health plans from Anthem Blue Cross and Blue Shield, CareSource, MedMutual, Molina Healthcare and Oscar Health Insurance and 1 other insurer list Lisa Blackwell 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 Blackwell was last updated on September 8, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 60 days 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.