Healthcare Provider Details

I. General information

NPI: 1285969675
Provider Name (Legal Business Name): KELCEY HIX
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2009
Last Update Date: 03/17/2025
Certification Date: 03/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 CHESTNUT ST
NORWALK CT
06854-3622
US

IV. Provider business mailing address

55 CHESTNUT ST
NORWALK CT
06854-3622
US

V. Phone/Fax

Practice location:
  • Phone: 203-851-1004
  • Fax:
Mailing address:
  • Phone: 203-851-1004
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number29370
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number079607
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number080792
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number014933
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: