MRS. LISETTE MIRA (LCSW) – Mental Health Counselor, NPI 1558694737

MRS. LISETTE MIRA (LCSW) is a healthcare provider. based in Miami springs, Florida. specializing in CLINICAL SOCIAL WORKER. They hold the professional credentials LCSW. They hold a License No. SW12313 (FL). The NPI Number for MRS. LISETTE MIRA (LCSW) is 1558694737

Main info

Female
14 Years Of Experience
Accepts Medicare Assignment
Name
MRS. LISETTE MIRA (LCSW)
NPI
1558694737
Phone
(305) 688-9000
Address
700 S ROYAL POINCIANA BLVD STE 300
Enumeration Date
7 September 2009
Last Update Date
15 March 2016

Doctor Profile

Medical School Name
OTHER
Secondary Phone
3052535100
Graduation Year
2012 (14 years ago)
PAC ID
4183964604
Group Practice PAC ID
6507770526
Professional Enrollment ID
I20190320001857
Address ID
FL331901003CU10300UNIT501
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience51
Completeness75
Years active:16State licenses:1Digital endpointsOther names

3,376 CLINICAL SOCIAL WORKER in FL

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Provider Addresses for MRS. LISETTE MIRA (LCSW)

  • 300, South Royal Poinciana Boulevard, Miami Springs, Miami-Dade County, Florida, 33166, United States

    MIAMI SPRINGS, FL 331666667

    Phone: (305) 688-9000

    Fax: (305) 662-1788

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2019-03-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20190320001857IClinical Social WorkerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 33166)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 6507770526View full group profile
NameSpecialtyState
Physician AssistantFL
Family PracticeFL
-FL
P S Y C H I A T R YFL
O B S T E T R I C S/ G Y N E C O L O G YFL
General PracticeFL
-FL
Nurse PractitionerFL
-FL
Physician AssistantFL

Reviews

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Frequently asked questions

What federal number belongs to MRS. LISETTE MIRA (LCSW)?
The federal identifier for MRS. LISETTE MIRA (LCSW) is NPI 1558694737.
Is MRS. LISETTE MIRA (LCSW) currently active in the NPI registry?
CMS-published data lists MRS. LISETTE MIRA (LCSW) as an active registrant.
What field does MRS. LISETTE MIRA (LCSW) work in?
You can think of MRS. LISETTE MIRA (LCSW) as practicing within Mental Health Counselor. Clinical services aligned with this taxonomy classification.
Where does public data place MRS. LISETTE MIRA (LCSW)?
The snapshot lists Miami Springs, Florida for MRS. LISETTE MIRA (LCSW); download NPPES for the complete set.
Is this NPI for an individual or an organization?
This listing corresponds to an Individual Provider.

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