Provider Demographics
NPI:1538317177
Name:KACI, LILJANA (LCSW)
Entity Type:Individual
Prefix:
First Name:LILJANA
Middle Name:
Last Name:KACI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:277 ORCHARD AVE
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-5439
Mailing Address - Country:US
Mailing Address - Phone:617-816-9011
Mailing Address - Fax:
Practice Address - Street 1:171 MARKET SQ STE 206B
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2930
Practice Address - Country:US
Practice Address - Phone:617-816-9011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-08
Last Update Date:2024-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1169311041C0700X
CT0094821041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical