Maria Cicero Barber, LPC

Individual provider Active NPI Professional Counselor · Moodus, CT

NPI 1831864636 · NPPES record last updated Aug 12, 2021

Key facts

NPI
1831864636
Entity type
Individual (NPI type 1)
Primary specialty
Professional Counselor 101YP2500X
License
3849 (CT)
Practice address
16 Rae Palmer Rd
Moodus, CT 06469-1195
Phone
(860) 883-8649
NPI assigned
Aug 12, 2021
Sex
Female
Sole proprietor
Yes

Organizations & group practices 1

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
000349CTMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Growth and Wellness Therapy, LLC Current
since Oct 24, 2021
Accepting new patients

Locations

16 Rae Palmer Rd
Moodus, CT 06469
Phone (860) 883-8649

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X 000349 CT
Professional Counselor 101YP2500X 3849 CT Yes

Addresses

Primary practice location

16 Rae Palmer Rd
Moodus, CT 06469-1195

Mailing address

123 Smith Rd
East Haddam, CT 06423-1251
Phone (860) 883-8649

Other providers in Moodus, CT

All providers in Moodus, CT · Professional Counselor in Connecticut

Sources for this page

Verify at the official NPI Registry.