VLADIMIR P LISENKO (LMHC.NCC) – Mental Health Counselor, NPI 1104013390

VLADIMIR P LISENKO (LMHC.NCC) is a healthcare provider. based in Issaquah, Washington. specializing in MENTAL HEALTH COUNSELOR. They hold the professional credentials LMHC.NCC. They hold a License No. LH00010867 (WA). The NPI Number for VLADIMIR P LISENKO (LMHC.NCC) is 1104013390

Main info

Male
Sole Proprietor
50 Years Of Experience
Accepts Medicare Assignment
Name
VLADIMIR P LISENKO (LMHC.NCC)
NPI
1104013390
Phone
(425) 736-6076
Address
310 3RD AVE NE
Enumeration Date
1 October 2007
Last Update Date
19 January 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
-
Graduation Year
1976 (50 years ago)
PAC ID
4082057088
Professional Enrollment ID
I20240207000178
Address ID
WA988319618Ma750XXDRXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience60
Completeness75
Years active:18State licenses:1Digital endpointsOther names

1,452 MENTAL HEALTH COUNSELOR in WA

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Provider Addresses for VLADIMIR P LISENKO (LMHC.NCC)

  • 310, 3rd Avenue Northeast, Issaquah, King County, Washington, 98027, United States

    SUITE 104

    ISSAQUAH, WA 980273300

    Phone: (425) 736-6076

    Fax: (425) 677-7599

    Type: Mailing

  • 750 LAKESHORE DR

    MANSON, WA 988319618

    Phone: (206) 714-9710

    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: 2024-02-07

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
I20240207000178IMental Health CounselorWATBD

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 98027)

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Reviews

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Frequently asked questions

How is VLADIMIR P LISENKO (LMHC.NCC) identified in CMS data?
CMS-hosted NPPES data lists VLADIMIR P LISENKO (LMHC.NCC) with NPI 1104013390.
Can I rely on VLADIMIR P LISENKO (LMHC.NCC) being an active provider?
As of the registry snapshot, VLADIMIR P LISENKO (LMHC.NCC) is marked active.
What is VLADIMIR P LISENKO (LMHC.NCC)'s specialty?
The listing groups VLADIMIR P LISENKO (LMHC.NCC) with Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where is VLADIMIR P LISENKO (LMHC.NCC) based?
VLADIMIR P LISENKO (LMHC.NCC) is tied to Issaquah, Washington in the data we show; additional addresses may exist on the full record.
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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