Healthcare Provider Details

I. General information

NPI: 1942914015
Provider Name (Legal Business Name): LISETTE CIFALDI LISW-CP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/12/2023
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23C SHELTER COVE LN
HILTON HEAD ISLAND SC
29928-3605
US

IV. Provider business mailing address

13 PLANTERS WOOD CT
HILTON HEAD ISLAND SC
29928-4403
US

V. Phone/Fax

Practice location:
  • Phone: 803-463-1010
  • Fax:
Mailing address:
  • Phone: 803-463-1010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number15446
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: