NPI Code Detail JSON Logo

1003771650 NPI number — LISA M MEOLA

NPI Number: 1003771650
Health Care Provider/Practitioner: LISA M MEOLA

Information about “1003771650” NPI (LISA M MEOLA) exists in 1003771650 in HTML format HTML  |  1003771650 in plain Text format TXT  |  1003771650 in PDF (Portable Document Format) PDF  |  1003771650 in an XML format XML  formats.

NPI Number : 1003771650 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1003771650",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "MEOLA",
    "FirstName": "LISA",
    "MiddleName": "M",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "315 S DURHAM ST",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "BALTIMORE",
    "MailingAddressStateName": "MD",
    "MailingAddressPostalCode": "21231-2519",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "443-909-8721",
    "MailingAddressFaxNumber": "443-909-8721",
    "FirstLinePracticeLocationAddress": "185 ADMIRAL COCHRANE DR STE 225",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ANNAPOLIS",
    "PracticeLocationAddressStateName": "MD",
    "PracticeLocationAddressPostalCode": "21401-7583",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "443-440-5780",
    "PracticeLocationAddressFaxNumber": "443-909-8721",
    "EnumerationDate": "12/17/2025",
    "LastUpdateDate": "12/17/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "101YA0400X",
        "TaxonomyName": "Addiction (Substance Use Disorder) Counselor",
        "LicenseNumber": "SC2865",
        "LicenseNumberStateCode": "MD",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2025 Data Labs Health. All rights reserved.