Maribeth Lichty, ACSW,LCSW,CAP

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW4548 Issued in FL

Practice address

5237 Summerlin Commons Blvd Ste 235
Fort Myers, FL 33907-2158

Phone

(239) 939-2939

Fax

(239) 432-0161

NPI assigned

Dec 27, 2007

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Oct 1, 2022 through Oct 1, 2026

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1198713600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1255515185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5237 SUMMERLIN COMMONS BLVD STE 235",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072158",
            "telephone_number": "239-939-2939",
            "fax_number": "239-432-0161"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5237 SUMMERLIN COMMONS BLVD STE 235",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339072158",
            "telephone_number": "239-939-2939",
            "fax_number": "239-432-0161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8695 College Pkwy",
            "address_2": "SUITE 1346",
            "address_purpose": "LOCATION",
            "city": "Fort Myers",
            "state": "FL",
            "postal_code": "339194809",
            "country_code": "US",
            "telephone_number": "239-939-2939",
            "fax_number": "239-432-0161",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICHTY",
        "first_name": "MARIBETH",
        "credential": "ACSW,LCSW,CAP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-12-27",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW4548",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jason P Licausi, LMFT
• Raymond Paul Liccini, M.D.
• Elizabeth De la Caridad Licea Fornaris
• Bryan V Lich, CCP
• Kathy Lichter, P.T.A.
• Amanda Lidgard, DO
• Claude P Lieber, MD
• Mark Ernest Liebetreu, OD
• Fred A Liebowitz, M.D.
• Katherine Lietz, MD PHD

• Clinical Social Worker in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.