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MRS. ANNETTE LICKWOLA LADC
NPI 1093557050
Counselor - Addiction (Substance Use Disorder) in New London, CT

Active since June 11, 2024PECOS Enrolled
931 BANK ST, NEW LONDON, CT 06320(860) 574-8256 Get Directions Write a Review

NPPES record last updated: October 31, 2024. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Mrs. Annette Lickwola Ladc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. ANNETTE LICKWOLA LADC (NPI 1093557050) is an individual addiction (substance use disorder) provider in New London, Connecticut, licensed in Connecticut (44.001570) and active in the NPI registry since June 2024. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1093557050
Entity TypeIndividualFemale
Primary Taxonomy101YA0400X
Provider Legal NameMRS. ANNETTE LICKWOLACredential: LADC
Location Address931 BANK STNew London, CT 06320-2702
Mailing Address931 Bank StNew London, CT 06320-2702 · (860) 574-8256
Phone(860) 574-8256
Sole ProprietorNo
Enumeration DateJune 11, 2024
Last NPPES UpdateOctober 31, 2024
NPPES CertifiedOctober 31, 2024
✔ NPI 1093557050 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers
Taxonomy Code101YA0400X
License✔ Licensed in CT · 44.001570
931 BANK ST, New London, CT 06320
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Annette Lickwola Ladc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer– Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 4

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MS. BARBARA A GOTAY MATTHEW LADC
Counselor (Addiction (Substance Use Disorder))
931 BANK ST
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-2233
MRS. MARIE VARGO LCSW
Social Worker (Clinical)
931 BANK ST
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-2233
MISS MYA PETCHARK LADC
Counselor (Addiction (Substance Use Disorder))
931 BANK ST
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 574-8252
SARA CYR LCSW
Social Worker (Clinical)
931 BANK ST
NEW LONDON, CT 06320
Southeastern Connecticut Planning Region (860) 447-2233

Frequently Asked Questions

What is Annette Lickwola's NPI number?

The NPI number assigned to this healthcare provider is 1093557050, enumerated as an "individual" on June 11, 2024.

Where is the provider located?

The provider is located at 931 BANK ST NEW LONDON, CT 06320 and the phone number is (860) 574-8256.

What is the provider's specialty?

Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).