Provider Demographics
NPI:1215701776
Name:RICCI, TORI (LCSW)
Entity type:Individual
Prefix:
First Name:TORI
Middle Name:
Last Name:RICCI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5415 LAKE HOWELL RD UNIT 239
Mailing Address - Street 2:
Mailing Address - City:WINTER PARK
Mailing Address - State:FL
Mailing Address - Zip Code:32792-1033
Mailing Address - Country:US
Mailing Address - Phone:850-723-6673
Mailing Address - Fax:
Practice Address - Street 1:645 BROOKWOOD LN
Practice Address - Street 2:
Practice Address - City:MAITLAND
Practice Address - State:FL
Practice Address - Zip Code:32751-5114
Practice Address - Country:US
Practice Address - Phone:850-723-6673
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW20781101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health