Provider Demographics
NPI:1457546152
Name:CICETTI, PATRICIA L (LMHC)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:L
Last Name:CICETTI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8130 MIMOSA PL
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33472-5020
Mailing Address - Country:US
Mailing Address - Phone:561-502-1638
Mailing Address - Fax:561-740-4788
Practice Address - Street 1:8130 MIMOSA PL
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-5020
Practice Address - Country:US
Practice Address - Phone:561-502-1638
Practice Address - Fax:561-740-4788
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLLMHC#6454101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL6454OtherLMHC