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NPI Code Detail

MEDICARE: LISA MARIE SICLARI

MEDICARE: LISA MARIE SICLARI
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health CounselorD-011138NY

General Provider Information

NPI Number : 1053968602
Entity Type Code : Individual
Provider Name (Legal Business Name) : LISA MARIE SICLARI
Provider Business Mailing Address
First Line : 2 CATAWBA CT
Second Line :
City : WEST NYACK
State : NY
Zip : 10994-2303
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 580 5TH AVE STE 820
Second Line :
City : NEW YORK
State : NY
Zip : 10036-4762
Country : US
Telephone Number : 212-470-0178
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2019
Last Update Date : 04/15/2026

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Directions to “ LISA MARIE SICLARI ” Practice Location

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