Lisa P. Mitchell, LMT, MLD-C

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

030106-02 Issued in NY

Practice address

1 Old Country Road, Suite 102
C/O Lisa Mitchell, Suite 408
Garden City, NY 11530

Phone

(516) 885-6011

NPI assigned

Jun 15, 2023

Sex

Female

Sole proprietor

Yes

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)

Not enrolled

State licenses

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

{
    "created_epoch": "1686787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1686787200000",
    "number": "1780369074",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "68 WEATHERBY LN",
            "city": "CENTRAL ISLIP",
            "state": "NY",
            "postal_code": "117224549",
            "telephone_number": "516-885-6011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 OLD COUNTRY ROAD, SUITE 102",
            "address_2": "C/O LISA MITCHELL, SUITE 408",
            "city": "GARDEN CITY",
            "state": "NY",
            "postal_code": "11530",
            "telephone_number": "516-885-6011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MITCHELL",
        "first_name": "LISA",
        "middle_name": "P.",
        "name_prefix": "Ms.",
        "credential": "LMT, MLD-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-15",
        "last_updated": "2023-06-15",
        "certification_date": "2023-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "NY",
            "license": "030106-02",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Christopher S Misciagno, MD
• Kelly Misevich
• Raquel Yvonne Mitchel, DPT
• Keiofia Katasha Mitchell
• Leona Mitchell, RN
• Ann M Mixon, MS CCC-SLP
• Modern OBGYN P.C
• Devanshi Sanjay Modi, PT
• Tanya Ann Modica, D.M.D
• Saul Michael Modlin, MD

• Massage Therapist in Garden City, NY
• Providers in Garden City, NY by specialty
• Massage Therapist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2023; 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.