Active NPI
Lisa Mazzotti, LMHC, CAP
- Counselor
- Punta Gorda, FL
National Provider Identifier
1215343033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- MH12675
- Practice address
- 1700 Education Ave
Punta Gorda, FL 33950-6222 - Phone
- (941) 639-8300
- Fax
- (941) 347-6455
- NPI assigned
- Jul 2, 2014
- Last updated
- Nov 9, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | MH12675 | FL | Primary |
Addresses
Primary practice location
1700 Education Ave
Punta Gorda, FL 33950-6222
Mailing address
1705 Colonial Blvd Ste B-1
Fort Myers, FL 33907
Phone (217) 825-8664
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in FL
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Mental Health Counselor
- Education
- Other, 1995
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
New York, NY 10087
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MH12675 | FL | MD | Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omar Rieche MD PA | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatry Physician
- Fort Myers, FL
- NPI 1760643860
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1404259200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1478649600000",
"number": "1215343033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1705 COLONIAL BLVD STE B-1",
"city": "FORT MYERS",
"state": "FL",
"postal_code": "33907",
"telephone_number": "217-825-8664",
"fax_number": "239-278-7785"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1700 EDUCATION AVE",
"city": "PUNTA GORDA",
"state": "FL",
"postal_code": "339506222",
"telephone_number": "941-639-8300",
"fax_number": "941-347-6455"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MAZZOTTI",
"first_name": "LISA",
"credential": "LMHC, CAP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2014-07-02",
"last_updated": "2016-11-09",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "FL",
"license": "MH12675",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Punta Gorda, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 9, 2016; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.