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General NPI Number Information
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NPI Number | 1215124847
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Entity Type | Organization
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Legal Business Name | LISA CICETTI PSYD LMHC INC.
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Dates
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Enumeration Date | 09/27/2007
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 2500 QUANTUM LAKES DR STE 203
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City | BOYNTON BEACH
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State | FL
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Zip | 33426-8323
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Country | US
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Telephone | 561-734-6118
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Fax | 561-369-3275
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Provider Business Mailing Address
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Address Line | 125 NEPTUNE DR
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City | HYPOLUXO
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State | FL
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Zip | 33462-6019
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Country | US
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Telephone | 561-734-6118
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Fax | 561-369-3275
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Authorized Official
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Title or Position | OWNER
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Name | DR. LISA CICETTI
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Credential | PSY.D., LMHC
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Telephone | 561-734-6118
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103T00000X
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Taxonomy Name | Psychologist
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License Number | PY 7715
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | PY7715
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License Number State | FL
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Taxonomy #3
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number | PY7715
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License Number State | FL
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Taxonomy #4
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MH 6095
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | PY7715
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License Number State | FL
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Taxonomy #6
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Taxonomy Code | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number | PY7715
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License Number State | FL
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Taxonomy #7
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Taxonomy Code | 103G00000X
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Taxonomy Name | Clinical Neuropsychologist
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License Number | PY7715
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License Number State | FL
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