Provider Demographics
NPI:1194032052
Name:MICHELOTTI, CECILE ELISABETH (LCSW)
Entity Type:Individual
Prefix:
First Name:CECILE
Middle Name:ELISABETH
Last Name:MICHELOTTI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:CECILE
Other - Middle Name:MICHELOTTI
Other - Last Name:CARTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2344 HANSEN LN UNIT 1
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32301-4884
Mailing Address - Country:US
Mailing Address - Phone:850-443-3902
Mailing Address - Fax:850-290-7450
Practice Address - Street 1:2344 HANSEN LN UNIT 1
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32301-4884
Practice Address - Country:US
Practice Address - Phone:850-443-3902
Practice Address - Fax:850-290-7450
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2021-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL117131041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical