Individual
NICOLE MICHELLE IANNELLI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCMHC
Contact information
Practice address
54 SYCAMORE DR, CRANSTON, RI 02921-1015
(401) 497-5108
Mailing address
54 SYCAMORE DR, CRANSTON, RI 02921-1015
(401) 497-5108
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
MHC00175
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
231701
BLUE CROSS BLUE SHIELD
RI
01
—
409945
BLUE CHIP
RI
01
—
470077
TUFTS
RI
01
—
6247759
UNITED HEALTH CARE
RI
05
—
NI43573
—
RI
Enumeration date
10/13/2006
Last updated
08/18/2016
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