Provider Demographics
NPI:1043407505
Name:GIGLIOTTI, CARL J (MA CLINICAL PSYCH)
Entity Type:Individual
Prefix:MR
First Name:CARL
Middle Name:J
Last Name:GIGLIOTTI
Suffix:
Gender:M
Credentials:MA CLINICAL PSYCH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 LEXINGTON PKWY
Mailing Address - Street 2:
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01201-7330
Mailing Address - Country:US
Mailing Address - Phone:413-499-6611
Mailing Address - Fax:
Practice Address - Street 1:48 LEXINGTON PKWY
Practice Address - Street 2:
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-7330
Practice Address - Country:US
Practice Address - Phone:413-499-6611
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-28
Last Update Date:2007-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA294101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA294OtherALLIED MENTAL HEALTH