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General NPI Number Information
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NPI Number | 1649198805
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Entity Type | Individual
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Provider Name | MICHAEL JOSEPH SACCOCCIO
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Gender | Male
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Dates
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Enumeration Date | 07/07/2026
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Last Update Date | 07/07/2026
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Provider Practice Location Address
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Address Line | 180 TINKHAM LN STE 1
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City | HARRISVILLE
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State | RI
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Zip | 02830-1444
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Country | US
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Telephone | 401-568-6469
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Fax |
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Provider Business Mailing Address
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Address Line | 36 HARRINGTON DR
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City | JOHNSTON
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State | RI
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Zip | 02919-6406
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | MHC00515-A
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License Number State | RI
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