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NPI Code Detail

MEDICARE: LISA CICETTI PSYD LMHC INC.

MEDICARE: LISA CICETTI PSYD LMHC INC.
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
1103T00000XPsychologistPY 7715FL
21041C0700XClinical Social WorkerPY7715FL
3251S00000XCommunity/Behavioral Health AgencyPY7715FL
4101YM0800XMental Health CounselorMH 6095FL
5253Z00000XIn Home Supportive Care AgencyPY7715FL
6291U00000XClinical Medical LaboratoryPY7715FL
7103G00000XClinical NeuropsychologistPY7715FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215124847
Entity Type Code : Organization
Provider Name (Legal Business Name) : LISA CICETTI PSYD LMHC INC.
Provider Business Mailing Address
First Line : 125 NEPTUNE DR
Second Line :
City : HYPOLUXO
State : FL
Zip : 33462-6019
Country : US
Telephone Number : 561-734-6118
Fax Number : 561-369-3275
Provider Business Practice Location Address
First Line : 2500 QUANTUM LAKES DR STE 203
Second Line :
City : BOYNTON BEACH
State : FL
Zip : 33426-8323
Country : US
Telephone Number : 561-734-6118
Fax Number : 561-369-3275
Authorized Official
Title or Position : OWNER
Name : DR. LISA CICETTI
Credential : PSY.D., LMHC
Telephone Number : 561-734-6118
Provider Enumeration Date : 09/27/2007
Last Update Date : 10/07/2025

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