Christina Lacivita
Counselor, Addiction (Substance Use Disorder) in Fort Worth, TX. Individual provider (NPI-1).
NPI number1669005245
StatusActive
Last updated in NPPESFeb 21, 2020
Details
- NPI
- 1669005245
- Entity type
- Individual (NPI-1)
- Name
- Christina Lacivita
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 21, 2020
- Certification date
- Feb 21, 2020
- Last updated
- Feb 21, 2020
Medicare and OIG
- Medicare enrolled (PECOS)
- Yes · PRACTITIONER - CLINICAL SOCIAL WORKER
- Can order and refer
- Part B Yes · DME Yes · Home health No · Power mobility No · Hospice No
- OIG exclusion list
- This NPI is not listed
CMS and OIG files of November 2026. PECOS lookup · OIG exclusion check
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 101YA0400X | Counselor, Addiction (Substance Use Disorder) | 64317 | TX | Yes |
Practice location
6115 Camp Bowie Blvd Ste 220Fort Worth, TX 76116-5543
Phone 817-381-0633
Mailing address
6115 Camp Bowie Blvd Ste 220Fort Worth, TX 76116-5543
Phone 817-381-0633
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This page shows exactly what the provider filed with NPPES. Only the provider (or their surrogate) can change it, by signing in to NPPES. Our page updates within a day of their change. See how to update NPI information.
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