Provider Demographics
NPI:1285969675
Name:HIX, KELCEY
Entity type:Individual
Prefix:
First Name:KELCEY
Middle Name:
Last Name:HIX
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:55 CHESTNUT ST
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:CT
Mailing Address - Zip Code:06854-3622
Mailing Address - Country:US
Mailing Address - Phone:203-851-1004
Mailing Address - Fax:
Practice Address - Street 1:55 CHESTNUT ST
Practice Address - Street 2:
Practice Address - City:NORWALK
Practice Address - State:CT
Practice Address - Zip Code:06854-3622
Practice Address - Country:US
Practice Address - Phone:203-851-1004
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-02
Last Update Date:2025-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079607104100000X
NY0807921041C0700X
NY29370101YA0400X
CT0149331041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)