Lyndsy Marie Mirasola, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

90200 Issued in CA

Practice address

11291 Dray Coury
Grass Valley, CA 95945-9594

Phone

(530) 205-3130

NPI assigned

Dec 5, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Medicare fee-for-service enrollment

Enrolled in CA, WI2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Quest Health Management Psychological Corporation

  • Community/Behavioral Health Agency
  • Chino, CA
  • NPI 1245791490
  Medicare reassignment NPD
• Mind Body Program LLC

  • Professional Counselor
  • Juneau, WI
  • NPI 1205084118
  Medicare reassignment NPD

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

{
    "created_epoch": "1417737600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754611200000",
    "number": "1053719138",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 W MCKNIGHT WAY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959499613",
            "telephone_number": "530-205-3130"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11291 DRAY COURY",
            "city": "GRASS VALLEY",
            "state": "CA",
            "postal_code": "959459594",
            "telephone_number": "530-205-3130"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRASOLA",
        "first_name": "LYNDSY",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-12-05",
        "last_updated": "2025-08-08",
        "certification_date": "2025-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "63657",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "CA",
            "license": "ASW63657",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "ASW63657",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "90200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Karen L Milman, M.D.
• Kelly Miner-Gann
• Veronica S Minier, MD
• Minor Everett Ward MD Inc
• Frank Weber Minor, M.D.
• Mahshideh Mirzadeh
• John Douglas Mitchell, DC
• MJ Silva Medical Corporation
• Maggie Moffitt
• Benjamin B Moller

• Clinical Social Worker in Grass Valley, CA
• Providers in Grass Valley, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.