Doctor Name: | KATHERINE CICHON |
NPI Number: | 1063835866 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LPC |
License Number: | 002415 |
Business Practice Address: | 300 State St Suite 307 New London, CT - 063206152 |
Business Phone Number: | 8609419380 |
Business Fax Number: | |
Mailing Address: | 300 State St, Suite 307 NEW LONDON |
State: | CT |
Postal Code: | 063206152 |
Phone Number: | 8609419380 |
Fax Number: | |
NPI Enumeration Date: | 01/29/2014 |
NPI Last Update Date: | 04/30/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YP2500X |
License Number: | 002415 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CT |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Professional |
Taxonomy Definition: |