Neurorecovery Inc

Primary specialty

Clinical NeuropsychologistTaxonomy code 103G00000X

License

PY7715 Issued in FL

Legal business name

NEURORECOVERY INC

Practice address

1101 N Congress Ave Ste 208
Boynton Beach, FL 33426-3336

Phone

(561) 734-6118

Fax

(561) 369-3275

NPI assigned

Dec 22, 2014

Organization subpart

No

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

Authorized official

Name

Lisa Cicetti, PSYD., LMHC

Title

Owner

Phone

(561) 734-6118

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1419206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1419206400000",
    "number": "1376931519",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1101 N CONGRESS AVE STE 208",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334263336",
            "telephone_number": "561-734-6118",
            "fax_number": "561-369-3275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1101 N CONGRESS AVE STE 208",
            "city": "BOYNTON BEACH",
            "state": "FL",
            "postal_code": "334263336",
            "telephone_number": "561-734-6118",
            "fax_number": "561-369-3275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEURORECOVERY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-12-22",
        "last_updated": "2014-12-22",
        "status": "A",
        "authorized_official_last_name": "CICETTI",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "561-734-6118",
        "authorized_official_credential": "PSYD., LMHC"
    },
    "taxonomies": [
        {
            "code": "103G00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Clinical Neuropsychologist",
            "state": "FL",
            "license": "PY7715",
            "primary": true
        },
        {
            "code": "103T00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY7715",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.