MEDICARE: MR. VICTOR INCERTI LPC

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	101YP2500X	Professional Counselor	000023	CT

General Provider Information

NPI Number	:	1922837046
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. VICTOR INCERTI LPC

Provider Business Mailing Address
First Line	:	1328 WILEY ST APT 303
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-2237
Country	:	US
Telephone Number	:	860-508-9312
Fax Number	:

Provider Business Practice Location Address
First Line	:	1328 WILEY ST APT 303
Second Line	:
City	:	HOLLYWOOD
State	:	FL
Zip	:	33019-2237
Country	:	US
Telephone Number	:	860-508-9312
Fax Number	:

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

Provider Enumeration Date	:	07/29/2024
Last Update Date	:	07/29/2024

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Directions to “ MR. VICTOR INCERTI LPC” Practice Location

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