Healthcare Provider Details

I. General information

NPI: 1952734089
Provider Name (Legal Business Name): DARYL J CIOFFI M.ED, C.A.G.S., LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2013
Last Update Date: 03/31/2020
Certification Date: 03/31/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1635 MINERAL SPRING AVE
NORTH PROVIDENCE RI
02904-4025
US

IV. Provider business mailing address

PO BOX 113987
NORTH PROVIDENCE RI
02911-0187
US

V. Phone/Fax

Practice location:
  • Phone: 401-349-4269
  • Fax:
Mailing address:
  • Phone: 401-349-4269
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberMHC00687
License Number StateRI
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License NumberMHC00687
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMHC00687
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: