Provider Demographics
NPI:1902643299
Name:KATIE CICHON LPC, LLC
Entity type:Organization
Organization Name:KATIE CICHON LPC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHERINE
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:CICHON
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:860-681-4611
Mailing Address - Street 1:147 WINDERMERE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-1363
Mailing Address - Country:US
Mailing Address - Phone:860-681-4611
Mailing Address - Fax:
Practice Address - Street 1:360 N MAIN ST STE 5
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2503
Practice Address - Country:US
Practice Address - Phone:860-681-4611
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-12
Last Update Date:2024-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty