# LUCIDITY WELLNESS GROUP LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1194590018
- **Authorized official:** LISA MARIE HARRIS PMHNP-BC, ACNS-BC (OWNER/PRACTICE MANAGER)
- **Authorized official phone:** (850) 215-4060

## Contact information

- **Practice address:** 803 JENKS AVE, STE 1A, PANAMA CITY, FL 32401
- **Practice address phone:** (850) 215-4060
- **Practice address fax:** (850) 481-1578
- **Mailing address:** 803 JENKS AVE, STE 1A, PANAMA CITY, FL 32401
- **Mailing address phone:** (850) 215-4060
- **Mailing address fax:** (850) 481-1578

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2084P0800X | Psychiatry Physician | — | — | — |
| 208D00000X | General Practice Physician | — | — | Yes |

## Other

- **Enumeration date:** 11/21/2023
- **Last updated:** 11/21/2023