Individual
CIRO ANTHONY MASSA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW LADC
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
000204
CT
1041C0700X
Clinical Social Worker
Primary
004254
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008004012
—
CT
Enumeration date
11/02/2006
Last updated
10/03/2024
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