Active NPI
Lisa Maria Ieraci, M.A, LCAT
- Poetry Therapist
- Douglaston, NY
National Provider Identifier
1891071858
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Poetry Therapist
- License
- 000069-1
- Practice address
- 243-02 Northern Blvd
Douglaston, NY 11362 - Phone
- (718) 423-6200
- NPI assigned
- Oct 22, 2011
- Last updated
- Oct 22, 2011
- 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 |
|---|---|---|---|---|
| Poetry Therapist | 102X00000X | 000069-1 | NY | Primary |
Addresses
Primary practice location
243-02 Northern Blvd
Douglaston, NY 11362
Mailing address
195-06A 39TH Ave
Auburndale, NY 11358
Phone (718) 423-6200
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 Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 000069-1 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1319241600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1319241600000",
"number": "1891071858",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195-06A 39TH AVE",
"city": "AUBURNDALE",
"state": "NY",
"postal_code": "11358",
"telephone_number": "718-423-6200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "243-02 NORTHERN BLVD",
"city": "DOUGLASTON",
"state": "NY",
"postal_code": "11362",
"telephone_number": "718-423-6200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IERACI",
"first_name": "LISA",
"middle_name": "MARIA",
"name_prefix": "Ms.",
"credential": "M.A, LCAT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-22",
"last_updated": "2011-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "102X00000X",
"taxonomy_group": "",
"desc": "Poetry Therapist",
"state": "NY",
"license": "000069-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglaston, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.