Provider Demographics
NPI:1861678708
Name:MARCIANTE, WILLIAM (RN, LPC, CPRP)
Entity Type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:
Last Name:MARCIANTE
Suffix:
Gender:M
Credentials:RN, LPC, CPRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 S BROAD ST
Mailing Address - Street 2:SUITE 1430
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19110-1023
Mailing Address - Country:US
Mailing Address - Phone:215-569-8414
Mailing Address - Fax:215-569-2021
Practice Address - Street 1:100 S BROAD ST
Practice Address - Street 2:SUITE 1430
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19110-1023
Practice Address - Country:US
Practice Address - Phone:215-569-8414
Practice Address - Fax:215-569-2021
Is Sole Proprietor?:No
Enumeration Date:2008-01-10
Last Update Date:2011-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN628023163W00000X
PAPC005353101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health