Provider Demographics
NPI:1356848840
Name:SALCEDO, LISA B (LCSW)
Entity type:Individual
Prefix:
First Name:LISA
Middle Name:B
Last Name:SALCEDO
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 1:6348 ETHAN DRIVE
Mailing Address - Street 2:
Mailing Address - City:LAKE WORTH
Mailing Address - State:FL
Mailing Address - Zip Code:33467-8732
Mailing Address - Country:US
Mailing Address - Phone:561-801-7577
Mailing Address - Fax:
Practice Address - Street 1:8198 JOG ROAD
Practice Address - Street 2:STE 105
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33472-2900
Practice Address - Country:US
Practice Address - Phone:561-801-7577
Practice Address - Fax:866-757-5778
Is Sole Proprietor?:No
Enumeration Date:2018-04-10
Last Update Date:2025-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW124151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical