Fnu Mailisi, LCSW

Individual provider Active NPI Clinical Social Worker · Town and Country, MO

NPI 1821813205 · NPPES record last updated Jul 21, 2026

Key facts

NPI
1821813205
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
2021044344 (MO)
Practice address
14323 S Outer 40 Rd
Town and Country, MO 63017-5739
Phone
(314) 325-6886
NPI assigned
Nov 20, 2024
Sex
Female
Sole proprietor
Yes

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20241204002185 MO Practitioner - Clinical Social Worker 4385170158 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
2021044344MOMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Deer Oaks Mental Health Associates PC Current
since Dec 1, 2024
Accepting new patients
Cedar Grove Counseling, LLC Clinical Past Accepting new patients

Locations

1300 County Farm Rd
Cassville, MO 65625
Phone (417) 847-3386

7272 Wurzbach Rd
Ste 601
San Antonio, TX 78240
Phone (210) 615-3472

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 2021044344 MO Yes

Addresses

Primary practice location

14323 S Outer 40 Rd
Town and Country, MO 63017-5739

Mailing address

14323 S Outer 40 Rd
Town and Country, MO 63017-5739
Phone (314) 325-6886

Other practice location 1

550 White Rd
Chesterfield, MO 63017-2316
Phone (888) 365-6271

Other names

  • Mai Lisi Professional name

Other providers in Town and Country, MO

All providers in Town and Country, MO · Clinical Social Worker in Missouri

Sources for this page

Verify at the official NPI Registry.