Active NPI
Charlie Fisette, LMFT
- Marriage & Family Therapist
- Clermont, FL
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Marriage & Family Therapist
- License
- MT4758
- Practice address
- 17011 State Road 50 Ste 301
Clermont, FL 34711-8203 - Phone
- (833) 769-3524
- Fax
- (352) 432-0106
- NPI assigned
- Oct 17, 2023
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | MT4758 | FL | Primary |
Addresses
Primary practice location
17011 State Road 50 Ste 301
Clermont, FL 34711-8203
Mailing address
17011 State Road 50 Ste 301
Clermont, FL 34711-8203
Phone (833) 769-3524
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Marriage and Family Therapist
- Education
- Other, 2020
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
17011 State Rd
50 Suite 301
Clermont, FL 34711-8203
Phone (352) 833-6300
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MT4758 | FL | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Personal Recovery Network LLC | Current | Accepting new patients |
Locations
4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392
17011 State Road 50
Ste 301
Clermont, FL 34711
Phone (352) 833-6300
8570 Granite Ct
Ste 101
Fort Myers, FL 33908
Phone (239) 310-4646
260 Lookout Pl
Ste 202
Maitland, FL 32751
Phone (407) 537-9450
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": "1697500800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1767571200000",
"number": "1619759362",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17011 STATE ROAD 50 STE 301",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347118203",
"telephone_number": "833-769-3524",
"fax_number": "352-432-0106"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17011 STATE ROAD 50 STE 301",
"city": "CLERMONT",
"state": "FL",
"postal_code": "347118203",
"telephone_number": "833-769-3524",
"fax_number": "352-432-0106"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FISETTE",
"first_name": "CHARLIE",
"credential": "LMFT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-17",
"last_updated": "2026-01-05",
"certification_date": "2026-01-05",
"status": "A"
},
"taxonomies": [
{
"code": "106H00000X",
"taxonomy_group": "",
"desc": "Marriage & Family Therapist",
"state": "FL",
"license": "MT4758",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Clermont, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.