Provider Demographics
NPI:1346597283
Name:CICCIO, ADAM (LMHC)
Entity Type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:CICCIO
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ATLANTIC AVE
Mailing Address - Street 2:UNIT 8
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-3042
Mailing Address - Country:US
Mailing Address - Phone:781-307-0098
Mailing Address - Fax:
Practice Address - Street 1:70 ATLANTIC AVENUE
Practice Address - Street 2:UNIT 8
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945
Practice Address - Country:US
Practice Address - Phone:781-307-0098
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-09
Last Update Date:2014-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health