Provider Demographics
NPI:1861738312
Name:CICARELLI, MAGDALENA R (LCSW)
Entity type:Individual
Prefix:MS
First Name:MAGDALENA
Middle Name:R
Last Name:CICARELLI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7301 WILES RD STE 107
Mailing Address - Street 2:
Mailing Address - City:CORAL SPRINGS
Mailing Address - State:FL
Mailing Address - Zip Code:33067-4105
Mailing Address - Country:US
Mailing Address - Phone:954-478-8568
Mailing Address - Fax:
Practice Address - Street 1:7301 WILES RD STE 107
Practice Address - Street 2:
Practice Address - City:CORAL SPRINGS
Practice Address - State:FL
Practice Address - Zip Code:33067-4105
Practice Address - Country:US
Practice Address - Phone:954-478-8568
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-02
Last Update Date:2018-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW80361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical