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General NPI Number Information
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NPI Number | 1972482800
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Entity Type | Individual
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Provider Name | SETH PICCOLO SR. LCDP
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Gender | Male
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 12/10/2025
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Provider Practice Location Address
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Address Line | 4705A OLD POST RD
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City | CHARLESTOWN
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State | RI
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Zip | 02813-1842
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Country | US
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Telephone | 401-364-7705
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Fax | 401-364-1982
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Provider Business Mailing Address
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Address Line | 15 LA SALLE SQ
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City | PROVIDENCE
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State | RI
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Zip | 02903-1814
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Country | US
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Telephone | 401-444-6779
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Fax | 401-444-6912
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | CDP01060
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License Number State | RI
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