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General NPI Number Information
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NPI Number | 1265246888
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Entity Type | Organization
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Legal Business Name | INTUITIVE JOURNEY COUNSELING SERVICES LLC
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 2389 MAIN ST STE 100
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City | GLASTONBURY
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State | CT
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Zip | 06033-4617
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Country | US
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Telephone | 860-266-6726
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 290019
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City | WETHERSFIELD
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State | CT
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Zip | 06129-0019
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Country | US
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Telephone | 860-670-2598
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Fax |
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Authorized Official
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Title or Position | OWNER/ CLINICIAN
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Name | MRS. KACI MOLLICA
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Credential | LCSW
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Telephone | 860-670-2598
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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