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Individual

MR. MICHAEL C. CERULLO JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MS, LMHC

Contact information

Practice address
60 LITTLE WOODS PATH, WAKEFIELD, RI 02879-1829
(401) 286-0804
(401) 295-8157
Mailing address
60 LITTLE WOODS PATH, WAKEFIELD, RI 02879-1829
(401) 286-0804
(401) 295-8157

Taxonomy

Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00171
RI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0000022750-001
BLUE CROSS/BLUE SHIELD RI
RI
01
00409983-001
BLUE CROSS BLUE CHIP
RI
01
1031070
NEIGHBORHOOD HEALTH RI
RI
01
62-77092
UNITED BEHAVIORAL HEALTH
RI
01
820288000
MAGELLAN
RI
05
MC45883
RI
Enumeration date
08/18/2006
Last updated
04/28/2025
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