DR. LISA MARIE TONNESSEN (PHD) – Professional Counselor, NPI 1083713119

DR. LISA MARIE TONNESSEN (PHD) is a healthcare provider. based in Groton, Connecticut. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials PHD. They hold a License No. 000387 (CT). The NPI Number for DR. LISA MARIE TONNESSEN (PHD) is 1083713119

Main info

Female
25 Years Of Experience
Accepts Medicare Assignment
Name
DR. LISA MARIE TONNESSEN (PHD)
NPI
1083713119
Phone
(860) 449-0200
Address
616 GOLDSTAR HGWY
Enumeration Date
22 September 2006
Last Update Date
8 July 2007

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8604490020
Graduation Year
2001 (25 years ago)
PAC ID
0345692703
Group Practice PAC ID
4385532373
Professional Enrollment ID
I20240122001841
Address ID
CT063406221GR616XXHWYX400
Telehealth
Yes
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience52
Completeness75
Years active:19State licenses:1Digital endpointsOther names

818 MENTAL HEALTH COUNSELOR in CT

Provider Addresses for DR. LISA MARIE TONNESSEN (PHD)

  • 616 GOLDSTAR HGWY

    SHORELINE COUNSELING

    GROTON, CT 06340

    Phone: (860) 449-0200

    Fax: (860) 449-1954

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2024-01-22

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240122001841IMental Health CounselorCTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 06340)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 4385532373View full group profile
NameSpecialtyState
Nurse PractitionerCT
Clinical Social WorkerRI
Physician AssistantCT
-CT
Nurse PractitionerCT
Nurse PractitionerCT
Clinical Social WorkerCT
Clinical Social WorkerCT
Mental Health CounselorCT
Marriage And Family TherapistCT

Reviews

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Frequently asked questions

Does DR. LISA MARIE TONNESSEN (PHD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — DR. LISA MARIE TONNESSEN (PHD) uses 1083713119.
Is DR. LISA MARIE TONNESSEN (PHD) listed as active for patients and plans?
The listing shows DR. LISA MARIE TONNESSEN (PHD) as active in the NPI system.
What is DR. LISA MARIE TONNESSEN (PHD)'s primary classification?
Professional Counselor is the headline specialty for DR. LISA MARIE TONNESSEN (PHD) here. Clinical services aligned with this taxonomy classification.
Does DR. LISA MARIE TONNESSEN (PHD) list a practice location?
Patients near Groton, Connecticut may find DR. LISA MARIE TONNESSEN (PHD) in results; validate coverage separately.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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