Provider Demographics
NPI:1588081533
Name:HUTTO, NICOLE ANN (BA, CADC, LCDP)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:ANN
Last Name:HUTTO
Suffix:
Gender:F
Credentials:BA, CADC, LCDP
Other - Prefix:MISS
Other - First Name:NICOLE
Other - Middle Name:ANN
Other - Last Name:PANCIOCCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:BA, CCSP
Mailing Address - Street 1:1052 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:CRANSTON
Mailing Address - State:RI
Mailing Address - Zip Code:02910-3225
Mailing Address - Country:US
Mailing Address - Phone:401-563-3685
Mailing Address - Fax:
Practice Address - Street 1:1052 PARK AVE
Practice Address - Street 2:
Practice Address - City:CRANSTON
Practice Address - State:RI
Practice Address - Zip Code:02910-3225
Practice Address - Country:US
Practice Address - Phone:401-563-3685
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-27
Last Update Date:2025-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)