Doctor Name: | MR. GUY ANTHONY CIANCIO |
NPI Number: | 1336468032 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | 6113 |
Business Practice Address: | 206 Canyon Ridge Dr Broad Brook, CT - 060169691 |
Business Phone Number: | 8607587861 |
Business Fax Number: | |
Mailing Address: | 206 Canyon Ridge Dr, BROAD BROOK |
State: | CT |
Postal Code: | 060169691 |
Phone Number: | 8607587861 |
Fax Number: | |
NPI Enumeration Date: | 05/20/2010 |
NPI Last Update Date: | 05/20/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 6113 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | MA |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |