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General NPI Number Information
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NPI Number | 1831864636
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Entity Type | Individual
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Provider Name | MARIA CICERO BARBER LPC
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Gender | Female
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Dates
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Enumeration Date | 08/12/2021
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Last Update Date | 08/12/2021
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Provider Practice Location Address
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Address Line | 16 RAE PALMER RD
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City | MOODUS
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State | CT
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Zip | 06469-1195
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Country | US
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Telephone | 860-883-8649
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Fax |
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Provider Business Mailing Address
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Address Line | 123 SMITH RD
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City | EAST HADDAM
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State | CT
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Zip | 06423-1251
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Country | US
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Telephone | 860-883-8649
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 000349
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 3849
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License Number State | CT
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