Individual
MARK IANNUCCILLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMHC
Contact information
Practice address
345 BLACKSTONE BLVD STE 2, PROVIDENCE, RI 02906-4800
(401) 276-4100
Mailing address
345 BLACKSTONE BLVD STE 2, PROVIDENCE, RI 02906-4829
(401) 276-4100
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC01956
RI
Other
Enumeration date
12/08/2025
Last updated
12/08/2025
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