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General NPI Number Information
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NPI Number | 1972135572
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Entity Type | Organization
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Legal Business Name | LISA SALCEDO LCSW PA
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Dates
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Enumeration Date | 02/11/2020
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 8198 JOG ROAD STE 105
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City | BOYNTON BEACH
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State | FL
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Zip | 33472-2900
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Country | US
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Telephone | 561-801-7577
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Fax | 866-757-5778
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Provider Business Mailing Address
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Address Line | 6348 ETHAN DRIVE
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City | LAKE WORTH
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State | FL
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Zip | 33467-8732
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Country | US
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Telephone | 561-801-7577
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Fax | 561-828-9272
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Authorized Official
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Title or Position | OWNER/MBR
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Name | LISA SALCEDO
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Credential | LCSW
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Telephone | 561-801-7577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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