Sugar Mill Body Renewal

Primary specialty

Massage TherapistTaxonomy code 225700000X

Legal business name

SUGAR MILL BODY RENEWAL

Practice address

200 Prescott Blvd Unit 201
Youngsville, LA 70592-7044

Phone

(240) 479-8860

NPI assigned

Jun 30, 2026

Organization subpart

No

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

Authorized official

Name

Lakisha Formica, LMTNPI 1861319147

Title

Owner / Massage Therapist

Phone

(804) 724-1618

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Lakisha Formica, LMT

  • Massage Therapist
  • Youngsville, LA
  • NPI 1861319147
  NPD (past) Authorized official

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

{
    "created_epoch": "1782777600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1782777600000",
    "number": "1437076700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 PRESCOTT BLVD UNIT 201",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705927044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PRESCOTT BLVD UNIT 201",
            "city": "YOUNGSVILLE",
            "state": "LA",
            "postal_code": "705927044",
            "telephone_number": "240-479-8860"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUGAR MILL BODY RENEWAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-06-30",
        "last_updated": "2026-06-30",
        "certification_date": "2026-06-30",
        "status": "A",
        "authorized_official_last_name": "FORMICA",
        "authorized_official_first_name": "LAKISHA",
        "authorized_official_title_or_position": "OWNER / MASSAGE THERAPIST",
        "authorized_official_telephone_number": "804-724-1618",
        "authorized_official_credential": "LMT"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.