Tracy Rose Cynthia Lisauskas, LMFT, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

145077 Issued in CA

Practice address

3504 Avenida del Presidente Apt 20
San Clemente, CA 92672-4533

Phone

(562) 261-4103

NPI assigned

Feb 28, 2024

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709078400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709078400000",
    "number": "1013774884",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33959 DOHENY PARK RD # 1010",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926754835",
            "telephone_number": "760-582-2590"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3504 AVENIDA DEL PRESIDENTE APT 20",
            "city": "SAN CLEMENTE",
            "state": "CA",
            "postal_code": "926724533",
            "telephone_number": "562-261-4103"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LISAUSKAS",
        "first_name": "TRACY ROSE",
        "middle_name": "CYNTHIA",
        "credential": "LMFT, MA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-02-28",
        "last_updated": "2024-02-28",
        "certification_date": "2024-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "CA",
            "license": "145077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Julia Leigh Levine, M.S., R.D.
• Cleveland Lewis Jr., M.D.,
• Pamela Lewis, M.A., CCC-SLP
• Michelle Liddell, BCBA
• Mi-Jin Lim, O.D.
• Sarah Kristine Little, PTA
• Colby Margaux Livingston, D.D.S.
• Sydney Loge
• Lisa Beth Lombardi, FNP, RN, BSN, BA, LE
• Linda Marie Long, FNP-BC

• Marriage & Family Therapist in San Clemente, CA
• Providers in San Clemente, CA by specialty
• Marriage & Family Therapist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.