Healthcare Provider Details

I. General information

NPI: 1225433600
Provider Name (Legal Business Name): MICHAEL CIPRIANI
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/28/2014
Last Update Date: 10/28/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

418 CHENEY ST
RENO NV
89502-0912
US

IV. Provider business mailing address

PO BOX 34171
RENO NV
89533-4171
US

V. Phone/Fax

Practice location:
  • Phone: 775-348-9047
  • Fax:
Mailing address:
  • Phone: 775-348-9047
  • 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: