Lisa Fracica, MA, LCPC, LGPAT

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

LC12493 Issued in MD

Practice address

2511 Stadium Dr
Charleston, SC 29406-6606

Phone

(816) 752-6631

Fax

(844) 919-1630

NPI assigned

May 15, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in SC

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 1

Specialty

Undefined Non-Physician Type (Specify)

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

Practice roles

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.

• Integrative Mind Body Therapy, LLC

  • Professional Counselor
  • Charleston, SC
  • NPI 1407594153
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1589500800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1698710400000",
    "number": "1245852946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "803 S ROSE ST",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212243740",
            "telephone_number": "816-752-6631"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2511 STADIUM DR",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294066606",
            "telephone_number": "816-752-6631",
            "fax_number": "844-919-1630"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRACICA",
        "first_name": "LISA",
        "name_prefix": "Ms.",
        "credential": "MA, LCPC, LGPAT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-05-15",
        "last_updated": "2023-10-31",
        "certification_date": "2023-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "221700000X",
            "taxonomy_group": "",
            "desc": "Art Therapist",
            "state": "MD",
            "license": "ATG239",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "MD",
            "license": "LC12493",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Germany Fox, MD
• Nicholas Ryan Fox, M.D.
• Oliver Samuel Fox, MD
• Rachel Holmes Fox, CRNA
• Ann Cheri Foxx, MD
• Jessica Lynn Fragile, APRN-NNP-BC
• Molly Fragopoulos, PA-C
• Latifa Fraiser
• J Wyman Frampton Jr., M.D.
• Taylor France

• Professional Counselor in Charleston, SC
• Providers in Charleston, SC by specialty
• Professional Counselor in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2023; 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.

Verify at the official NPI Registry.