Provider Demographics
NPI:1134303050
Name:MACIOCI, MICHAEL ANTHONY (MA, MFT)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:MACIOCI
Suffix:
Gender:M
Credentials:MA, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3024 WILLOW PASS RD
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94519-2588
Mailing Address - Country:US
Mailing Address - Phone:925-681-4131
Mailing Address - Fax:925-646-5505
Practice Address - Street 1:3024 WILLOW PASS RD
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94519-2588
Practice Address - Country:US
Practice Address - Phone:925-681-4131
Practice Address - Fax:925-646-5505
Is Sole Proprietor?:No
Enumeration Date:2007-12-27
Last Update Date:2014-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health