Individual provider Active NPI

Marilisa Lawless, MS

  • Marriage & Family Therapist
  • Davie, FL
National Provider Identifier
1760606057
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
MT0001505 Issued in FL
Practice address
4431 SW 64TH Ave
Suite 107-108
Davie, FL 33314-3458
Phone
(954) 797-7430
Fax
(954) 797-6782
NPI assigned
Apr 11, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X MT0001505 FL Primary

Addresses

Primary practice location

4431 SW 64TH Ave
Suite 107-108
Davie, FL 33314-3458

Mailing address

4431 SW 64TH Ave
Suite 107-108
Davie, FL 33314-3458
Phone (954) 797-7430

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
MT0001505FLMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1760606057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4431 SW 64TH AVE",
            "address_2": "SUITE 107-108",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143458",
            "telephone_number": "954-797-7430",
            "fax_number": "954-797-6782"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4431 SW 64TH AVE",
            "address_2": "SUITE 107-108",
            "city": "DAVIE",
            "state": "FL",
            "postal_code": "333143458",
            "telephone_number": "954-797-7430",
            "fax_number": "954-797-6782"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LAWLESS",
        "first_name": "MARILISA",
        "name_prefix": "Ms.",
        "credential": "MS",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-11",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "FL",
            "license": "MT0001505",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Davie, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.