Active NPI
Lucidity Wellness Group LLC
- General Practice Physician
- Panama City, FL
National Provider Identifier
1194590018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- Legal business name
- LUCIDITY WELLNESS GROUP LLC
- Practice address
- 803 Jenks Ave
Ste 1a
Panama City, FL 32401 - Phone
- (850) 215-4060
- Fax
- (850) 481-1578
- NPI assigned
- Nov 21, 2023
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Lisa Marie Harris, PMHNP-BC, ACNS-BC
- Title
- Owner/Practice Manager
- Phone
- (850) 215-4060
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | |||
| General Practice Physician | 208D00000X | Primary |
Addresses
Primary practice location
803 Jenks Ave
Ste 1a
Panama City, FL 32401
Mailing address
803 Jenks Ave
Ste 1a
Panama City, FL 32401
Phone (850) 215-4060
National Provider Directory
National Provider DirectoryLocations
803 Jenks Ave
Ste 1A
Panama City, FL 32401
Phone (850) 215-4060
Practitioners & affiliated clinicians
Practitioners 2
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Psychiatric/Mental Health Nurse Practitioner
- Panama City, FL
- NPI 1609395110
-
- Behavior Technician
- Callaway, FL
- NPI 1033814611
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1700524800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1700524800000",
"number": "1194590018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "803 JENKS AVE",
"address_2": "STE 1A",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "32401",
"telephone_number": "850-215-4060",
"fax_number": "850-481-1578"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "803 JENKS AVE",
"address_2": "STE 1A",
"city": "PANAMA CITY",
"state": "FL",
"postal_code": "32401",
"telephone_number": "850-215-4060",
"fax_number": "850-481-1578"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "LUCIDITY WELLNESS GROUP LLC",
"organizational_subpart": "NO",
"enumeration_date": "2023-11-21",
"last_updated": "2023-11-21",
"certification_date": "2023-11-21",
"status": "A",
"authorized_official_last_name": "HARRIS",
"authorized_official_first_name": "LISA",
"authorized_official_middle_name": "MARIE",
"authorized_official_title_or_position": "OWNER/PRACTICE MANAGER",
"authorized_official_telephone_number": "850-215-4060",
"authorized_official_credential": "PMHNP-BC, ACNS-BC"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": null,
"license": null,
"primary": false
},
{
"code": "208D00000X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "General Practice",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Panama City, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.