Provider Demographics
NPI:1437893450
Name:WYTRYKOWSKA, KAROLINA A (LPC, LADC)
Entity Type:Individual
Prefix:
First Name:KAROLINA
Middle Name:A
Last Name:WYTRYKOWSKA
Suffix:
Gender:F
Credentials:LPC, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:203 STODDARD AVE # 203
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-1926
Mailing Address - Country:US
Mailing Address - Phone:860-518-4687
Mailing Address - Fax:
Practice Address - Street 1:107 FENN RD
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2250
Practice Address - Country:US
Practice Address - Phone:860-518-4687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-04-26
Last Update Date:2022-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1429101YA0400X
CT5440101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)