Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 101YA0400X | Addiction Counselor (Substance Use Disorder) | 000151 | VT |
NPI | 1003919051 |
---|---|
Provider Name | Peter Loiacono |
First Address | West Chesterfield, NH 03466-0541 |
Second Address | Keene, NH 03431-3257 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/09/2006 |
Last Update Date | 21/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000151 | VERMONT ALCOHOL AND DRUG COUNSELOR CERTIFICATION BOARD (01) | VT |
0588 | NEW HAMPSHIRE BOARD OF ALCOHOL &OTHER DRUG ABUSE PROFESSIONAL PRACTICE (01) | NH |
2221 | MASSACHUSETTS BUREAU OF SUBSTANCE ABUSE SERVICES (01) | MA |