Cicero, John Charles

Cicero, John Charles is an individual health care provider with primary practice located at 1007 N Main St , Dayville CT 06241-2170. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Cicero, John Charles can be contacted via phone (860) 774-2020.

Contact Information

Primary practice address
1007 N Main St Dayville CT 06241-2170
Fax: (860) 779-5437
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X ISW01940 Rhode Island

Profile Details

NPI number 1427246909
LBN Legal business name Cicero, John Charles
Credentials MSW, LICSW
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 9th, 2007
Last updated Mar 10th, 2011 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1427246909 NPPES
Connecticut MEDICAID 004040564

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