Healthcare Provider Details

I. General information

NPI: 1700113974
Provider Name (Legal Business Name): KELLY REPICCI LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2009
Last Update Date: 06/15/2025
Certification Date: 06/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 ABBOTTS HILL RD
NEWTOWN CT
06470-2421
US

IV. Provider business mailing address

4 ABBOTTS HILL RD
NEWTOWN CT
06470-2421
US

V. Phone/Fax

Practice location:
  • Phone: 203-441-1406
  • Fax:
Mailing address:
  • Phone: 203-441-1406
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000916
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number001723
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: