Lisa A Mitton, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

1346 Issued in ID

Practice address

414 Shoup Ave W Ste B
Twin Falls, ID 83301-5042

Phone

(208) 814-9100

Fax

(208) 814-9903

NPI assigned

Feb 15, 2012

Last updated

Feb 15, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• St Luke's Magic Valley Regional Medical Center LTD

  dba St Lukes Retail Pharmacy Twin Falls

  • Community/Retail Pharmacy
  • Twin Falls, ID
  • NPI 1760203921
  NPD (past)

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

{
    "created_epoch": "1329264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1329264000000",
    "number": "1750654109",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "414 SHOUP AVE W STE B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015042",
            "telephone_number": "208-814-9100",
            "fax_number": "208-814-9903"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "414 SHOUP AVE W STE B",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015042",
            "telephone_number": "208-814-9100",
            "fax_number": "208-814-9903"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITTON",
        "first_name": "LISA",
        "middle_name": "A",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-15",
        "last_updated": "2012-02-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ID",
            "license": "1346",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ravae Minton, MSW, LCSW
• Miranda Medical, PLLC
• A. Richard Miranda, MD
• Cortney R Mitchell, AUD,BS,AA
• Rosemary L Mitchell, LMSW
• Maverick Mitton, FNP-C
• M Andrew Mix, RPT
• Mitchell Jackson Moffitt, M.D.
• Stanley Mogelson, M.D.
• Rebecca Ann Molina, FNP

• Clinical Social Worker in Twin Falls, ID
• Providers in Twin Falls, ID by specialty
• Clinical Social Worker in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2012; 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.