Active NPI
Kenyatia McLish, LMT
- Massage Therapist
- Old Saybrook, CT
National Provider Identifier
1821738808
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- 010630
- Practice address
- 49 Sherwood Ter
Old Saybrook, CT 06475-2144 - Phone
- (248) 217-1646
- NPI assigned
- Mar 29, 2022
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | 010630 | CT | Primary |
Addresses
Primary practice location
49 Sherwood Ter
Old Saybrook, CT 06475-2144
Mailing address
7 N Main St Unit 1234
Old Saybrook, CT 06475-4243
Phone (248) 217-1646
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010630 | CT | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1648512000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1648512000000",
"number": "1821738808",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "7 N MAIN ST UNIT 1234",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "064754243",
"telephone_number": "248-217-1646"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "49 SHERWOOD TER",
"city": "OLD SAYBROOK",
"state": "CT",
"postal_code": "064752144",
"telephone_number": "248-217-1646"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCLISH",
"first_name": "KENYATIA",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-03-29",
"last_updated": "2022-03-29",
"certification_date": "2022-03-29",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "CT",
"license": "010630",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Old Saybrook, CT
- MC Diagnostic of Connecticut, P.C.
- James R McAraw, D.M.D.
- Amanda Rau McKenna
- Craig Edward McKnight, M.D.
- Michelle McLain, LPC
- Garth Eric Meadows, R.PH.
- Medical Center Pharmacy and Home Care Center, Inc.
- Medoptions Behavioral Health Assoc, LLC
- Medoptions Behavioral Health Associates
- Medoptions Behavioral Health Associates
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.