Lydia Catherine Cicarelli, CPC

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

CG61227010 Issued in WA

Practice address

901 N Monroe St Ste 201
Spokane, WA 99201-2148

Phone

(509) 608-8816

NPI assigned

Dec 10, 2021

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1639094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639094400000",
    "number": "1407515026",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5211 N WASHINGTON ST",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992055141",
            "telephone_number": "509-216-3057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 N MONROE ST STE 201",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992012148",
            "telephone_number": "509-608-8816"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CICARELLI",
        "first_name": "LYDIA",
        "middle_name": "CATHERINE",
        "credential": "CPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-12-10",
        "last_updated": "2021-12-10",
        "certification_date": "2021-12-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "WA",
            "license": "CG61227010",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "CG61227010",
            "state": "WA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "ReviveCounselingSpokane",
            "affiliation": "N",
            "endpointDescription": "MentalHelath",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "901 N Monroe St Ste 201",
            "city": "Spokane",
            "state": "WA",
            "country_code": "US",
            "postal_code": "992012148",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Christopher K Chun, DPT
• Dominic Chun
• Jason H Chung
• Kimberly M Chupurdia, PHD
• Erin A Church, MD
• Cynthia L Cilyo, MD
• Dena Ciminelli
• Cinder & Fern Counseling, PLLC
• Michael A Cioffi
• Jenny Lynn Ciolli

• Peer Specialist in Spokane, WA
• Providers in Spokane, WA by specialty
• Peer Specialist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2021; 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.