MEDICARE: MR. LAWRENCE JOSEPH GALLICHIO LMHC,CAP

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	438	FL
2	101YM0800X	Mental Health Counselor	4097	FL

General Provider Information

NPI Number	:	1821136276
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. LAWRENCE JOSEPH GALLICHIO LMHC,CAP

Provider Business Mailing Address
First Line	:	6270 N ANDREWS AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-2129
Country	:	US
Telephone Number	:	954-772-7696
Fax Number	:	954-977-3085

Provider Business Practice Location Address
First Line	:	6270 N ANDREWS AVE
Second Line	:
City	:	FT LAUDERDALE
State	:	FL
Zip	:	33309-2129
Country	:	US
Telephone Number	:	954-772-7696
Fax Number	:	954-977-3085

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

Provider Enumeration Date	:	02/01/2007
Last Update Date	:	09/11/2025

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