Provider Demographics
NPI:1881656197
Name:ALICATA, KATHLEEN MORIN (LCSW)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:MORIN
Last Name:ALICATA
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 1:2 CHESTNUT HILL RD
Mailing Address - Street 2:
Mailing Address - City:WILTON
Mailing Address - State:CT
Mailing Address - Zip Code:06897-4624
Mailing Address - Country:US
Mailing Address - Phone:203-834-9867
Mailing Address - Fax:
Practice Address - Street 1:HIP HEALTH PLAN OF NEW YORK
Practice Address - Street 2:55 WATER STREET
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10041-8190
Practice Address - Country:US
Practice Address - Phone:646-447-7249
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0719841041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical