Cicely Calvaresi-Holston, LPC

Primary specialty

Professional CounselorTaxonomy code 101YP2500X

License

PC016640 Issued in PA

Practice address

2 Woodland Rd Lowr Level
Wyomissing, PA 19610-1999

Phone

(484) 222-8282

NPI assigned

May 3, 2021

Last updated

Apr 26, 2025By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other names 1

• Phoenix Wellness LLC DBS Cicely Holston Counseling Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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

• Phoenix Wellness LLC

  dba Cicely Holston Counseling

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Wyomissing, PA
  • NPI 1871321661
  NPD Authorized official

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

{
    "created_epoch": "1620000000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1548843121",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 WHITFIELD BLVD",
            "city": "READING",
            "state": "PA",
            "postal_code": "196091138",
            "telephone_number": "484-222-8282"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WOODLAND RD LOWR LEVEL",
            "city": "WYOMISSING",
            "state": "PA",
            "postal_code": "196101999",
            "telephone_number": "484-222-8282"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALVARESI-HOLSTON",
        "first_name": "CICELY",
        "credential": "LPC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-05-03",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC016640",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "PHOENIX WELLNESS LLC",
            "last_name": "CICELY HOLSTON COUNSELING",
            "middle_name": "DBS",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lindsey Jane Buynovsky, CRNP
• Dania Cabello-Ruiz
• Victor Alfonso Cabral, LCSW
• Peter D Calder, M.D.
• Heather Lynn Calloway
• Ryan Mikhail David Calvi, D.M.D.
• Karen Ann V Cameron, OTD MED OTR/L
• Steven Paul Cammarano, DPT
• Carlee Cammerota
• Vincent James Campanile IV, LPC, MA, MS, NCC

• Professional Counselor in Wyomissing, PA
• Providers in Wyomissing, PA by specialty
• Professional Counselor in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2025; 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.