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NPI Code Detail

MEDICARE: STEPHEN R RICCO

MEDICARE: STEPHEN R RICCO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YA0400XAddiction (Substance Use Disorder) Counselor

General Provider Information

NPI Number : 1134645856
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHEN R RICCO
Provider Business Mailing Address
First Line : 48 PAOLINO ST APT 3
Second Line :
City : JOHNSTON
State : RI
Zip : 02919-5430
Country : US
Telephone Number : 401-601-5476
Fax Number :
Provider Business Practice Location Address
First Line : 985 PLAINFIELD ST
Second Line :
City : JOHNSTON
State : RI
Zip : 02919-6703
Country : US
Telephone Number : 401-601-5476
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/15/2017
Last Update Date : 01/30/2026

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Directions to “ STEPHEN R RICCO ” Practice Location

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