Lisa Anne Mazzio, PSY.D, LCP

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

0810004778 Issued in VA

Practice address

1600 Colonial Ave
Norfolk, VA 23517-2020

Phone

(757) 354-1422

NPI assigned

Jun 30, 2013

Sex

Female

Sole proprietor

No

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

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Oct 4, 2016 through Oct 4, 2026

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Watermark Psychological Services

  • Clinical Psychologist
  • Norfolk, VA
  • NPI 1891191805
  NPD (past) Authorized official

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

{
    "created_epoch": "1372550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1372550400000",
    "number": "1992145338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1600 COLONIAL AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235172020",
            "telephone_number": "757-354-1422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 COLONIAL AVE",
            "city": "NORFOLK",
            "state": "VA",
            "postal_code": "235172020",
            "telephone_number": "757-354-1422"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAZZIO",
        "first_name": "LISA",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "PSY.D, LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-30",
        "last_updated": "2013-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "VA",
            "license": "0810004778",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Suzanne May
• Travis Hasan May
• Edward Kevin Maybury, DO
• Rabeea Mazhar, M.B.B.S.
• Samantha Mazza, MD
• Lauren Wasson Mazzurco, D.O.
• Ikechukwu Valentine Mbonu, MD
• Charles Rupert McAdams III
• Bailey Gill McAlas, MD
• William McAllister

• Clinical Psychologist in Norfolk, VA
• Providers in Norfolk, VA by specialty
• Clinical Psychologist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.