Healthcare Provider Details

I. General information

NPI: 1417067562
Provider Name (Legal Business Name): THOMAS JOSEPH CIAPPINA LPC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 BROAD ST
DUBLIN VA
24084
US

IV. Provider business mailing address

5981 WILDERNESS RD
DUBLIN VA
24084
US

V. Phone/Fax

Practice location:
  • Phone: 540-674-4506
  • Fax: 540-674-4507
Mailing address:
  • Phone: 540-674-6543
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number0701001895
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: