Provider Demographics
NPI:1285235994
Name:MACCINI, MARC (MED LMHC)
Entity type:Individual
Prefix:MR
First Name:MARC
Middle Name:
Last Name:MACCINI
Suffix:
Gender:M
Credentials:MED LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 HUMPHREY ST APT 3
Mailing Address - Street 2:
Mailing Address - City:SWAMPSCOTT
Mailing Address - State:MA
Mailing Address - Zip Code:01907-2514
Mailing Address - Country:US
Mailing Address - Phone:781-820-8017
Mailing Address - Fax:
Practice Address - Street 1:44 HUMPHREY ST APT 3
Practice Address - Street 2:
Practice Address - City:SWAMPSCOTT
Practice Address - State:MA
Practice Address - Zip Code:01907-2514
Practice Address - Country:US
Practice Address - Phone:781-820-8017
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA3883101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor