Provider Demographics
NPI:1811043359
Name:PACIOCCO, MARTHA MILES (MA, LPC)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:MILES
Last Name:PACIOCCO
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 TAN BARK PLAZA
Mailing Address - Street 2:
Mailing Address - City:LOVINGSTON
Mailing Address - State:VA
Mailing Address - Zip Code:22949
Mailing Address - Country:US
Mailing Address - Phone:434-263-4889
Mailing Address - Fax:
Practice Address - Street 1:71 TAN BARK PLAZA
Practice Address - Street 2:
Practice Address - City:LOVINGSTON
Practice Address - State:VA
Practice Address - Zip Code:22949
Practice Address - Country:US
Practice Address - Phone:434-263-4889
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2012-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional