MEDICARE: TERRI ANN CICILESS

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CAC	FL

General Provider Information

NPI Number	:	1528910866
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERRI ANN CICILESS

Provider Business Mailing Address
First Line	:	4680 OAK TERRACE DR
Second Line	:
City	:	GREENACRES
State	:	FL
Zip	:	33463-3732
Country	:	US
Telephone Number	:	561-315-0264
Fax Number	:

Provider Business Practice Location Address
First Line	:	900 N CONGRESS AVE
Second Line	:
City	:	BOYNTON BEACH
State	:	FL
Zip	:	33426-3303
Country	:	US
Telephone Number	:	561-223-6484
Fax Number	:

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

Provider Enumeration Date	:	02/10/2026
Last Update Date	:	02/10/2026

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Directions to “ TERRI ANN CICILESS ” Practice Location

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