LISA JEANNE MADDOX – Professional Counselor, NPI 1013632116

LISA JEANNE MADDOX is a healthcare provider. based in Atlanta, Georgia. specializing in MENTAL HEALTH COUNSELOR. They hold a License No. MH22914 (FL). The NPI Number for LISA JEANNE MADDOX is 1013632116

Main info

Female
5 Years Of Experience
Accepts Medicare Assignment
Name
LISA JEANNE MADDOX
NPI
1013632116
Phone
(855) 284-7483
Address
PO BOX 748465
Enumeration Date
11 October 2022
Last Update Date
27 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9045076712
Graduation Year
2021 (5 years ago)
PAC ID
8426408733
Group Practice PAC ID
5496173577
Professional Enrollment ID
I20231228003751
Address ID
FL322578975JA4243XRDXX301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience35
Completeness75
Years active:3State licenses:1Digital endpointsOther names

3,018 MENTAL HEALTH COUNSELOR in FL

Provider Addresses for LISA JEANNE MADDOX

  • PO BOX 748465

    ATLANTA, GA 303748465

    Phone: (855) 284-7483

    Fax: (617) 807-0958

    Type: Mailing

  • 4243 SUNBEAM RD STE 1

    JACKSONVILLE, FL 322578975

    Phone: (855) 284-7483

    Fax: (617) 807-0958

    Type: Location

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: 2023-12-28

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
I20231228003751IMental Health CounselorFLTBD

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 30374)

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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: 5496173577View full group profile
NameSpecialtyState
Mental Health CounselorCO
Mental Health CounselorFL
Mental Health CounselorFL
Nurse PractitionerFL
Mental Health CounselorGA
Nurse PractitionerFL
Mental Health CounselorFL
Nurse PractitionerFL
Mental Health CounselorFL
Mental Health CounselorVA

Reviews

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Frequently asked questions

What identifier follows LISA JEANNE MADDOX across health systems?
The NPI 1013632116 uniquely identifies LISA JEANNE MADDOX in U.S. healthcare data.
Does the public listing show LISA JEANNE MADDOX as active?
LISA JEANNE MADDOX's NPI record reflects an active status in NPPES.
What does the directory say LISA JEANNE MADDOX does?
Insurance directories may phrase it differently, but here LISA JEANNE MADDOX maps to Professional Counselor. Clinical services aligned with this taxonomy classification.
Which community is linked to LISA JEANNE MADDOX?
LISA JEANNE MADDOX shows a connection to Atlanta, Georgia in registry-derived data.
Why is information missing for LISA JEANNE MADDOX?
Providers choose how much contact data to publish. Missing fields do not mean the profile is fake.

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