CMS-1500 Box 24J / 33a • NPI
1174906028
Type 1 Individual Rendering/Ordering
HIPAA NUCC Taxonomy • CMS Code
363LP0808X (CMS 50)
Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health
Box 32 Service Location & ZIP+4
39 N CLINTON AVE BLDG 1, TRENTON, NJ, 08609-1011
✓ 9-Digit EDI 837 ZIP+4 (08609-1011)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1174906028 (LISA MERRITT, DNP, APN, PMHNP, NE) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1174906028 (NPI-1 Individual Practitioner) |
|---|---|
| Provider / Legal Name | LISA MERRITT, DNP, APN, PMHNP, NE |
| Plain-English Specialty | Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health NUCC Code: 363LP0808X (Nurse Practitioner, Psych/Mental Health) |
| Certifying / Licensing Body | State Medical / Healthcare Licensing Board & National Specialty Board |
| Practice Location Address | 39 N CLINTON AVE BLDG 1, TRENTON, NJ, 08609-1011 |
| Practice Telephone / Fax | Tel: (609) 396-4557 |
| Administrative Mailing Address | 39 N CLINTON AVE, TRENTON, NJ, 08609-1011 |
| Enumeration & Last Sync | Enumerated: 2015-07-09 | CMS Record Updated: 2026-05-12 |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (363LP0808X)
What Does Taxonomy Code 363LP0808X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 363LP0808X translates to:
"Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (LISA MERRITT, DNP, APN, PMHNP, NE)
Typical CPT / Diagnostic Procedures:- Comprehensive Outpatient & Inpatient Clinical Evaluation (CPT 99202–99215)
- Diagnostic Workup, Laboratory Ordering & Evidence-Based Care Coordination
- Preventive Screening, Patient Counseling & Multidisciplinary Referral
- Evidence-Based Specialty Pharmacotherapy & Preventive Regimens (CMS Part D Standard)
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: PA | License: NPPA074716 | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: SC | License: APN.30179RX | Primary: Secondary |
163W00000X — Registered NursePlain English: Licensed & Credentialed Registered Nurse | State: NJ | License: 27NR17056100 | Primary: Secondary |
363LP0808X — Nurse Practitioner, Psych/Mental HealthPlain English: Licensed & Credentialed Physician Assistants & Advanced Practice Nursing Providers — Nurse Practitioner, Psychiatric — Mental Health | State: NJ | License: 26NJ15048700 | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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