Lisa Marie Kicinski, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

114 S Main St Ste 28And32
Cheshire, CT 06410-3111

Phone

(860) 348-5614

NPI assigned

May 31, 2022

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Supportive Solutions Behavioral Health and Wellness LLC

  • Clinical Social Worker
  • Hamden, CT
  • NPI 1598260226
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1653955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733356800000",
    "number": "1073252912",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "114 S MAIN ST STE 28AND32",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103111",
            "telephone_number": "806-348-5614"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 S MAIN ST STE 28AND32",
            "city": "CHESHIRE",
            "state": "CT",
            "postal_code": "064103111",
            "telephone_number": "860-348-5614"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KICINSKI",
        "first_name": "LISA",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-31",
        "last_updated": "2024-12-05",
        "certification_date": "2024-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CT",
            "license": "14684",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Kenning, OTR/L
• Jennifer Lynne Kenworthy, LMSW
• Stacie Leigh Kervin, LPC, NCC
• Shahmeen Khan
• Judith Frances Khericha, RPT
• Michele Marie Kieras, LCSW
• Chloe Rose Kiernan
• Kimberly Jewell, LMFT LLC
• Kindred Psychotherapy and Consultation PLLC
• Karalyn Kinsella, MD

• Social Worker in Cheshire, CT
• Providers in Cheshire, CT by specialty
• Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.