Jason P Licausi, LMFT

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

MT3395 Issued in FL

Practice address

3049 Cleveland Ave
Fort Myers, FL 33901-7041

Phone

(239) 826-4870

NPI assigned

Jul 3, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

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": "1499040000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1841711538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3617 CANOPY CIR",
            "city": "NAPLES",
            "state": "FL",
            "postal_code": "34120",
            "telephone_number": "239-826-4870"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3049 CLEVELAND AVE",
            "city": "FORT MYERS",
            "state": "FL",
            "postal_code": "339017041",
            "telephone_number": "239-826-4870"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9990 Coconut Rd",
            "address_purpose": "LOCATION",
            "city": "Estero",
            "state": "FL",
            "postal_code": "341358488",
            "country_code": "US",
            "telephone_number": "239-317-3115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3617 Canopy Cir",
            "address_purpose": "LOCATION",
            "city": "Naples",
            "state": "FL",
            "postal_code": "341200699",
            "country_code": "US",
            "telephone_number": "239-826-4870",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LICAUSI",
        "first_name": "JASON",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "LMFT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-07-03",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "IMT2296",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MT3395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Li Li, M.D.
• Sui Li, M.D.
• Yu-Hsuan Liao, M.D.
• Daniil Libman, APN
• Lisa Libonati, FNP-BC, APRN, MSN
• Raymond Paul Liccini, M.D.
• Elizabeth De la Caridad Licea Fornaris
• Bryan V Lich, CCP
• Kathy Lichter, P.T.A.
• Maribeth Lichty, ACSW,LCSW,CAP

• Mental Health Counselor in Fort Myers, FL
• Providers in Fort Myers, FL by specialty
• Mental Health Counselor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.