MAISY LEE PHRAVORAXAY MSW
NPI 1104550482
Counselor - Mental Health in Clearwater, FL

Q: What is Maisy Phravoraxay's NPI number?

The NPI number for Maisy Phravoraxay is 1104550482. It was assigned to this individual provider in the NPPES registry on July 13, 2022.

Q: What is Maisy Phravoraxay's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Q: When was this NPI record last updated?

The NPPES record for Maisy Phravoraxay was last updated on August 1, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 13, 2022PECOS EnrolledAccepts Medicare Assignment

2188 58TH ST N, CLEARWATER, FL 33760(727) 327-7656 Get Directions Write a Review

NPPES record last updated: August 1, 2022. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 1, 2022, Jul 13, 2022 (2 updates tracked since 2022).

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About Maisy Lee Phravoraxay Msw NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MAISY LEE PHRAVORAXAY MSW (NPI 1104550482) is an individual mental health provider in Clearwater, Florida, licensed in Minnesota (29219) and active in the NPI registry since July 2022. She is enrolled in Medicare PECOS and is a graduate of Other (2020).

NPPES Registry Identity

NPI1104550482

Entity TypeIndividualFemale

Primary Taxonomy101YM0800X

Provider Legal NameMAISY LEE PHRAVORAXAYCredential: MSW

Location Address2188 58TH ST NClearwater, FL 33760-3112

Mailing AddressPo Box 10970Saint Petersburg, FL 33733-0970 · (727) 327-7656

Phone(727) 327-7656

Sole ProprietorYes

Medical School CMSOtherGraduated 2020

Enumeration DateJuly 13, 2022

Last NPPES UpdateAugust 1, 20222 updates tracked since enumeration

NPPES CertifiedAugust 1, 2022

✔ NPI 1104550482 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers

Taxonomy Code101YM0800X

License✔ Licensed in MN · 29219

2188 58TH ST N, Clearwater, FL 33760

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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include HealthPartners.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Maisy Lee Phravoraxay Msw is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID2961847017

PECOS Enrollment IDI20240228001552

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EMMA GEISDORF

Counselor (Mental Health)