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Individual

MARCY TALICEO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MA, LMHC, LPC

Contact information

Practice address
25 HIGH ST, ENFIELD, CT 06082
(860) 698-6077
(860) 698-6631
Mailing address
25 HIGH ST, ENFIELD, CT 06082-3410
(860) 698-6077
(860) 698-6631

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
8146
MA
101YP2500X
Professional Counselor
Primary
2378
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
008045179
CT
Enumeration date
03/30/2011
Last updated
09/05/2018
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