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Individual

DEREK CIARUFFOLI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPC

Contact information

Practice address
675 WYOMING AVE, SUITE B, KINGSTON, PA 18704-3831
(570) 406-9350
Mailing address
11 SNOWDEN ST, FORTY FORT, PA 18704-5009
(570) 406-9350

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
101YM0800X
Mental Health Counselor
Primary
PC008743
PA

Other

Enumeration date
06/30/2014
Last updated
11/29/2016
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