Healthcare Provider Details

I. General information

NPI: 1104231331
Provider Name (Legal Business Name): PETER JOSEPH CIANCI LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2014
Last Update Date: 12/11/2025
Certification Date: 12/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4030 WAKE FOREST RD STE 349
RALEIGH NC
27609-0010
US

IV. Provider business mailing address

4030 WAKE FOREST RD STE 349
RALEIGH NC
27609-0010
US

V. Phone/Fax

Practice location:
  • Phone: 919-637-6306
  • Fax:
Mailing address:
  • Phone: 919-637-6306
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC010182
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: