Provider Demographics
NPI:1285754416
Name:RICCI-CIANCITTO, DINA MARIE (LPC, MS)
Entity type:Individual
Prefix:MRS
First Name:DINA
Middle Name:MARIE
Last Name:RICCI-CIANCITTO
Suffix:
Gender:F
Credentials:LPC, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LAMP POST LN
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08003-1311
Mailing Address - Country:US
Mailing Address - Phone:856-489-3996
Mailing Address - Fax:
Practice Address - Street 1:105 LAMP POST LN
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-1311
Practice Address - Country:US
Practice Address - Phone:856-489-3996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00356600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ202192OtherNATIONAL BOARD CERT COUNS
NJ566514OtherSUBSTANCE AWARENESS COORD
NJ37PC00356600OtherLICENSED PROFESSINAL COUN