Provider Demographics
NPI:1881465045
Name:MARCEAU, ALICIA MARIE (LPC)
Entity type:Individual
Prefix:MRS
First Name:ALICIA
Middle Name:MARIE
Last Name:MARCEAU
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BROOKSIDE DR
Mailing Address - Street 2:
Mailing Address - City:PLAINFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06374-1135
Mailing Address - Country:US
Mailing Address - Phone:860-271-1669
Mailing Address - Fax:
Practice Address - Street 1:225 PROVIDENCE PIKE
Practice Address - Street 2:
Practice Address - City:PUTNAM
Practice Address - State:CT
Practice Address - Zip Code:06260-2526
Practice Address - Country:US
Practice Address - Phone:860-928-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT7004101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional