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NPI Code Detail

MEDICARE: MR. JOHN LOUIS SANNICANDRO LMHC

MEDICARE: MR. JOHN LOUIS SANNICANDRO LMHC
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 Counselor5037MA

General Provider Information

NPI Number : 1497814453
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. JOHN LOUIS SANNICANDRO LMHC
Provider Business Mailing Address
First Line : 22 LONG AVE
Second Line :
City : FRAMINGHAM
State : MA
Zip : 01702-5736
Country : US
Telephone Number : 508-875-7419
Fax Number :
Provider Business Practice Location Address
First Line : 20 MAIN ST
Second Line : SUITE 300
City : NATICK
State : MA
Zip : 01760-4525
Country : US
Telephone Number : 508-259-2078
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/06/2006
Last Update Date : 07/08/2007

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