Provider Demographics
NPI:1669930426
Name:MOLLICA, KACI (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KACI
Middle Name:
Last Name:MOLLICA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:KACI
Other - Middle Name:
Other - Last Name:COURTEMANCHE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:23 TIMBER TRL
Mailing Address - Street 2:
Mailing Address - City:WETHERSFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06109-1452
Mailing Address - Country:US
Mailing Address - Phone:860-670-2598
Mailing Address - Fax:
Practice Address - Street 1:23 TIMBER TRL
Practice Address - Street 2:
Practice Address - City:WETHERSFIELD
Practice Address - State:CT
Practice Address - Zip Code:06109-1452
Practice Address - Country:US
Practice Address - Phone:860-670-2598
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-11
Last Update Date:2025-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101Y00000XBehavioral Health & Social Service ProvidersCounselor