Healthcare Provider Details

I. General information

NPI: 1376431114
Provider Name (Legal Business Name): ANTHONY CIPRIANO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2025
Last Update Date: 06/27/2025
Certification Date: 06/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

450 PEARL ST STE 3&3B
STOUGHTON MA
02072-1610
US

IV. Provider business mailing address

100 TAUNTON ST UNIT B218
PLAINVILLE MA
02762-1246
US

V. Phone/Fax

Practice location:
  • Phone: 508-212-3230
  • Fax:
Mailing address:
  • Phone: 508-808-4571
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: