Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michael John Formica, LPC

Individual provider Mental Health Counselor · NPI 1174688311

Michael John Formica, LPC is a Mental Health Counselor in Groton, Connecticut. Practices as a sole proprietor. Licensed in Connecticut.

Licensed in
CT
In the registry since
2006
What do these letters mean?
LPC — Licensed Professional Counselor
A licensed mental health counsellor.

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Practice location Address checks out

616 Gold Star Hwy
Groton, CT 06340-6221
Phone: (860) 449-0200
Fax: (860) 449-1954
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence 000869 (CT)

Record details

NPI number1174688311
Entity typeIndividual (Type 1)
GenderMale
Credentials LPC
Sole proprietorYes
NPI enumeratedDecember 27, 2006
Last updated in NPPESJuly 8, 2007
Mailing address32 Sea Crest Ave, Niantic, CT 06357-3808

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