Provider Demographics
NPI:1962757161
Name:RON CIPRIANO AND ASSICIATES IN COUNSELING LLC
Entity type:Organization
Organization Name:RON CIPRIANO AND ASSICIATES IN COUNSELING LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:STEPHEN
Authorized Official - Middle Name:A
Authorized Official - Last Name:JOHNSON
Authorized Official - Suffix:
Authorized Official - Credentials:MS
Authorized Official - Phone:904-503-2637
Mailing Address - Street 1:9471 BAYMEADOWS DR.SUITE 301
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32256
Mailing Address - Country:US
Mailing Address - Phone:904-503-2634
Mailing Address - Fax:904-503-2637
Practice Address - Street 1:9471 BAYMEADOWS RD
Practice Address - Street 2:301
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32256-7932
Practice Address - Country:US
Practice Address - Phone:904-503-2634
Practice Address - Fax:904-503-2637
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-13
Last Update Date:2013-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPMH251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health