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NPI Code Detail

MEDICARE: KELLI VACIRCA

MEDICARE: KELLI VACIRCA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1205788999
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLI VACIRCA
Provider Business Mailing Address
First Line : 125 HARTWELL AVE
Second Line :
City : LEXINGTON
State : MA
Zip : 02421-3100
Country : US
Telephone Number : 781-861-0890
Fax Number :
Provider Business Practice Location Address
First Line : 125 HARTWELL AVE
Second Line :
City : LEXINGTON
State : MA
Zip : 02421-3100
Country : US
Telephone Number : 781-861-0890
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2026
Last Update Date : 02/13/2026

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Directions to “ KELLI VACIRCA ” Practice Location

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