LISA S. DEITERS (LPC) – Mental Health Counselor, NPI 1538477328

LISA S. DEITERS (LPC) is a healthcare provider. based in Holland, Michigan. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LPC. They hold a License No. 6401009532 (MI). The NPI Number for LISA S. DEITERS (LPC) is 1538477328

Main info

Female
21 Years Of Experience
Accepts Medicare Assignment
Name
LISA S. DEITERS (LPC)
NPI
1538477328
Phone
(616) 730-1556
Address
503 CENTURY LN STE 2
Enumeration Date
15 September 2010
Last Update Date
6 May 2026

Doctor Profile

Medical School Name
OTHER
Secondary Phone
6167950298
Graduation Year
2005 (21 years ago)
PAC ID
1052763026
Group Practice PAC ID
6901175082
Professional Enrollment ID
I20240116002472
Address ID
MI494234318HO503XXLNXX301
Data current as of
3 June 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience59
Completeness85
Years active:15State licenses:1Digital endpointsOther names

2,023 MENTAL HEALTH COUNSELOR in MI

Provider Addresses for LISA S. DEITERS (LPC)

  • 503 CENTURY LN STE 2

    HOLLAND, MI 494234318

    Phone: (616) 730-1556

    Type: Location

  • 1346 Baldwin St

    Jenison, MI 494288937

    Phone: (616) 765-8585

    Fax: (616) 333-8116

    Type: Location

  • 3300 36TH ST SE

    GRAND RAPIDS, MI 495122810

    Phone: (616) 831-5661

    Fax: (616) 831-5628

    Type: Mailing

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: 2024-01-16

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
I20240116002472IMental Health CounselorMITBD

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 49423)

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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: 6901175082View full group profile
NameSpecialtyState
Clinical Social WorkerMI
Clinical Social WorkerMI
Mental Health CounselorMI
Clinical Social WorkerMI
Clinical Social WorkerMI
Clinical PsychologistOH
Clinical Social WorkerMI
Mental Health CounselorMI
Mental Health CounselorMI
Mental Health CounselorMI

Reviews

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Frequently asked questions

Is LISA S. DEITERS (LPC) listed with a National Provider Identifier?
Yes — LISA S. DEITERS (LPC) has NPI 1538477328 on file in the registry.
Active or inactive — what applies to LISA S. DEITERS (LPC)?
You should see LISA S. DEITERS (LPC) as active in CMS-hosted NPPES data.
What area of care is associated with LISA S. DEITERS (LPC)?
LISA S. DEITERS (LPC)'s record emphasizes Mental Health Counselor. Clinical services aligned with this taxonomy classification.
What locale is associated with LISA S. DEITERS (LPC)?
Directory geography for LISA S. DEITERS (LPC) centers on Holland, Michigan.
What does 5 location(s) imply?
5 practice locations appear in the available data.

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