Individual provider Active NPI

Marisa McGrath

  • Counselor
  • Lakeland, FL
National Provider Identifier
1104765395
Registry record updated Mar 25, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
IMH23057 Issued in FL
Practice address
120 E Pine St Ste 10
Lakeland, FL 33801-4982
Phone
(863) 670-4333
NPI assigned
Mar 25, 2026
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 25, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X IMH23057 FL Primary

Addresses

Primary practice location

120 E Pine St Ste 10
Lakeland, FL 33801-4982

Mailing address

120 E Pine St Ste 10
Lakeland, FL 33801-4982
Phone (863) 670-4333

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
IMH23057FLMDCounselor

NPI Registry JSON

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

{
    "created_epoch": "1774396800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1774396800000",
    "number": "1104765395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "120 E PINE ST STE 10",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014982",
            "telephone_number": "863-670-4333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 E PINE ST STE 10",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338014982",
            "telephone_number": "863-670-4333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MCGRATH",
        "first_name": "MARISA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-03-25",
        "last_updated": "2026-03-25",
        "certification_date": "2026-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "FL",
            "license": "IMH23057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakeland, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2026; 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.