Provider Demographics
NPI:1366142069
Name:DOUCETTE, KAITLYN (LPC)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:
Last Name:DOUCETTE
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2264 SILAS DEANE HWY STE 100
Mailing Address - Street 2:
Mailing Address - City:ROCKY HILL
Mailing Address - State:CT
Mailing Address - Zip Code:06067-2333
Mailing Address - Country:US
Mailing Address - Phone:860-805-8279
Mailing Address - Fax:
Practice Address - Street 1:2264 SILAS DEANE HWY STE 100
Practice Address - Street 2:
Practice Address - City:ROCKY HILL
Practice Address - State:CT
Practice Address - Zip Code:06067-2333
Practice Address - Country:US
Practice Address - Phone:860-245-1864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-09
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT006102101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional