LISA J DABERKOW STALP (PHD) – Psychologist, NPI 1063603561

LISA J DABERKOW STALP (PHD) is a healthcare provider. based in Kansas city, Missouri. specializing in CLINICAL PSYCHOLOGIST. They hold the professional credentials PHD. They hold a License No. 01859 (MO). The NPI Number for LISA J DABERKOW STALP (PHD) is 1063603561

Main info

Female
30 Years Of Experience
Accepts Medicare Assignment
Name
LISA J DABERKOW STALP (PHD)
NPI
1063603561
Phone
(816) 751-7900
Address
3011 BALTIMORE AVE
Enumeration Date
8 August 2007
Last Update Date
6 May 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8167517832
Graduation Year
1996 (30 years ago)
PAC ID
0840354676
Group Practice PAC ID
0143116368
Professional Enrollment ID
I20090122000694
Address ID
MO641083403KA3011XAVEX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience50
Completeness75
Years active:18State licenses:1Digital endpointsOther names

449 CLINICAL PSYCHOLOGIST in MO

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Provider Addresses for LISA J DABERKOW STALP (PHD)

  • 3011, Baltimore Avenue, Union Hill, Kansas City, Jackson County, Missouri, 64108, United States

    KANSAS CITY, MO 641083403

    Phone: (816) 751-7900

    Fax: (816) 751-7981

    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: 2009-01-22

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
I20090122000694IClinical PsychologistMOTBD

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.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
96159Treatment of behavior impacting health, each additional 15 minutes2517$0
96158Treatment of behavior impacting health, initial 30 minutes2418$0
96156Assessment of health behavior1919$0
View full utilization report →

Insurance plans in this area (ZIP 64108)

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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: 0143116368View full group profile
NameSpecialtyState
Family Practice, Internal MedicineKS
Family PracticeKS
Physical Medicine And RehabilitationNE
Internal Medicine, Pediatric MedicineKS
Internal MedicineMO
Family PracticeMO
Clinical PsychologistMO
Emergency Medicine, Family Practice, Sports MedicineMO
Family PracticeMO
Internal Medicine, HospitalistKS

Reviews

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Frequently asked questions

Does LISA J DABERKOW STALP (PHD) share an NPI with anyone else?
NPI numbers are unique to each provider or organization — LISA J DABERKOW STALP (PHD) uses 1063603561.
Is LISA J DABERKOW STALP (PHD) listed as active for patients and plans?
The listing shows LISA J DABERKOW STALP (PHD) as active in the NPI system.
What is LISA J DABERKOW STALP (PHD)'s specialty?
The listing groups LISA J DABERKOW STALP (PHD) with Psychologist. Clinical services aligned with this taxonomy classification.
What address line appears for LISA J DABERKOW STALP (PHD)?
LISA J DABERKOW STALP (PHD)'s geographic hint is Kansas City, Missouri in our summary view.
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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