Provider Demographics
NPI:1346398757
Name:CICIONE, ROBERT MICHAEL (LICSW)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:CICIONE
Suffix:
Gender:M
Credentials:LICSW
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Mailing Address - Street 1:1395 ATWOOD AVE
Mailing Address - Street 2:CROSSROAD COMMONS SUITE 209
Mailing Address - City:JOHNSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02919
Mailing Address - Country:US
Mailing Address - Phone:401-943-7667
Mailing Address - Fax:401-944-8222
Practice Address - Street 1:1395 ATWOOD AVE
Practice Address - Street 2:CROSSROAD COMMONS SUITE 209
Practice Address - City:JOHNSTON
Practice Address - State:RI
Practice Address - Zip Code:02919
Practice Address - Country:US
Practice Address - Phone:401-943-7667
Practice Address - Fax:401-944-8222
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIISW005031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical