Provider Demographics
NPI:1134689623
Name:LARICCHIUTI, ANTHONY (LMFT)
Entity Type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:
Last Name:LARICCHIUTI
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:251 LARRY WINKLER RD
Mailing Address - Street 2:
Mailing Address - City:BOONE
Mailing Address - State:NC
Mailing Address - Zip Code:28607-7109
Mailing Address - Country:US
Mailing Address - Phone:919-666-7097
Mailing Address - Fax:
Practice Address - Street 1:251 LARRY WINKLER RD
Practice Address - Street 2:
Practice Address - City:BOONE
Practice Address - State:NC
Practice Address - Zip Code:28607-7109
Practice Address - Country:US
Practice Address - Phone:919-666-7097
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-21
Last Update Date:2022-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2184106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist