Provider Demographics
NPI:1710101357
Name:LISCIO, MICHELE (LMFT, CFLE)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:
Last Name:LISCIO
Suffix:
Gender:F
Credentials:LMFT, CFLE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 COLLEGE AVE
Mailing Address - Street 2:BRIEF THERAPY INSTITUTE
Mailing Address - City:DAVIE
Mailing Address - State:FL
Mailing Address - Zip Code:33314-7721
Mailing Address - Country:US
Mailing Address - Phone:954-849-3277
Mailing Address - Fax:
Practice Address - Street 1:3301 COLLEGE AVE
Practice Address - Street 2:BRIEF THERAPY INSTITUTE
Practice Address - City:DAVIE
Practice Address - State:FL
Practice Address - Zip Code:33314-7721
Practice Address - Country:US
Practice Address - Phone:954-849-3277
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2010-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 2157106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLMT 2157OtherLICENSED MFT