Provider Demographics
NPI:1932621745
Name:GIORDANO, PACIFIC THOMAS (LCSW, LADC)
Entity Type:Individual
Prefix:MR
First Name:PACIFIC
Middle Name:THOMAS
Last Name:GIORDANO
Suffix:
Gender:M
Credentials:LCSW, LADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:641 PEDDLERS RD
Mailing Address - Street 2:
Mailing Address - City:GUILFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06437-4313
Mailing Address - Country:US
Mailing Address - Phone:203-843-5071
Mailing Address - Fax:203-732-1529
Practice Address - Street 1:10 PROGRESS DR
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6216
Practice Address - Country:US
Practice Address - Phone:203-538-6244
Practice Address - Fax:203-732-1529
Is Sole Proprietor?:No
Enumeration Date:2017-07-13
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT1245101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT008074397Medicaid
CT008074397Medicaid
CT008068631Medicaid