Individual provider Active NPI

Michael Louis Cicalese, LMHC

  • Mental Health Counselor
  • Greenacres, FL
National Provider Identifier
1073393476
Registry record updated Oct 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
MH22827 Issued in FL
Practice address
6803 Lake Worth Rd Ste 215
Greenacres, FL 33467-2979
Phone
(561) 207-7625
NPI assigned
Oct 3, 2023
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 30, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X MH22827 FL Primary

Addresses

Primary practice location

6803 Lake Worth Rd Ste 215
Greenacres, FL 33467-2979

Mailing address

18505 Kitty Hawk CT
Port Saint Lucie, FL 34987-3213
Phone (772) 408-7445

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240611001827 FL Practitioner - Mental Health Counselor 6507308178 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Psywell LLCGroup PAC ID 5294277810, 6 clinicians

Practice addresses (Care Compare)

6803 Lake Worth Rd
Suite 215
Greenacres, FL 33467-2979
Phone (561) 207-7625

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
MH22827FLMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Psywell, LLC Mental Health CurrentSince Jul 1, 2024 Accepting new patients

Locations

6803 Lake Worth Rd
#215
Greenacres, FL 33467
Phone (561) 207-7625

6803 Lake Worth Rd
Ste 215
Greenacres, FL 33467
Phone (561) 207-7625

8401 Lake Worth Rd
#210
Lake Worth, FL 33467
Phone (561) 207-7625

8401 Lake Worth Rd
Ste 210
Lake Worth, FL 33467
Phone (561) 267-3831

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1696291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730246400000",
    "number": "1073393476",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18505 KITTY HAWK CT",
            "city": "PORT SAINT LUCIE",
            "state": "FL",
            "postal_code": "349873213",
            "telephone_number": "772-408-7445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6803 LAKE WORTH RD STE 215",
            "city": "GREENACRES",
            "state": "FL",
            "postal_code": "334672979",
            "telephone_number": "561-207-7625"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICALESE",
        "first_name": "MICHAEL",
        "middle_name": "LOUIS",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-10-03",
        "last_updated": "2024-10-30",
        "certification_date": "2024-10-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH22827",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenacres, FL

Sources for this page

Verify at the official NPI Registry.