MEDICARE: ANDREA LICARI-CRITCHLEY LPC, LMHC, NCC, MA

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
1	101Y00000X	Counselor	37AC00253600	NJ
2	101Y00000X	Counselor	MH26452	FL

Other Identifiers

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

General Provider Information

NPI Number	:	1518332600
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREA LICARI-CRITCHLEY LPC, LMHC, NCC, MA

Provider Business Mailing Address
First Line	:	7901 4TH ST N STE 300
Second Line	:
City	:	ST PETERSBURG
State	:	FL
Zip	:	33702-4399
Country	:	US
Telephone Number	:	908-415-0870
Fax Number	:

Provider Business Practice Location Address
First Line	:	124 SIX STRING DR
Second Line	:
City	:	DAYTONA BEACH
State	:	FL
Zip	:	32124-1167
Country	:	US
Telephone Number	:	908-415-0870
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2015
Last Update Date	:	01/17/2026

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