Christina Lacivita

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

64317 Issued in TX

Practice address

6115 Camp Bowie Blvd Ste 220
Fort Worth, TX 76116-5543

Phone

(817) 381-0633

NPI assigned

Feb 21, 2020

Sex

Female

Sole proprietor

No

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

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Salyer Counseling Group PLLCGroup PAC ID 2860806429, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

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 and National Provider Directory roles.

• Salyer Counseling Group, PLLC

  • Mental Health Counselor
  • Pantego, TX
  • NPI 1093317802
  Medicare reassignment Care Compare group NPD
• Arise Recovery Centers of America, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fort Worth, TX
  • NPI 1629580287
  NPD

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

{
    "created_epoch": "1582243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1582243200000",
    "number": "1669005245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6115 CAMP BOWIE BLVD STE 220",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165543",
            "telephone_number": "817-381-0633"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6115 CAMP BOWIE BLVD STE 220",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761165543",
            "telephone_number": "817-381-0633"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACIVITA",
        "first_name": "CHRISTINA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-21",
        "last_updated": "2020-02-21",
        "certification_date": "2020-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "64317",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Labs 2 Go
• Rachel Labus
• David Anthony Lacerda, PH.D.
• Romar Lacey
• Laura Kennedy Lachman, MD
• Darren Wayne Lackan, M.D.
• Cassie Lackey, PT
• Horace Grady Lackey III, LPC
• Megan Lackey
• Kelli Lynne Lacroix, MD, PHD

• Addiction (Substance Use Disorder) Counselor in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2020; 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.

Verify at the official NPI Registry.