Healthcare Provider Details

I. General information

NPI: 1427730258
Provider Name (Legal Business Name): KACEY ELIZABETH FRIEDMAN LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/02/2023
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

61 S MAIN ST STE 209
WEST HARTFORD CT
06107-2403
US

IV. Provider business mailing address

61 S MAIN ST STE 209
WEST HARTFORD CT
06107-2403
US

V. Phone/Fax

Practice location:
  • Phone: 860-251-9617
  • Fax:
Mailing address:
  • Phone: 860-251-9617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number9767
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: