Guy Anthony Ciancio, LMHC
Individual provider Active NPI Mental Health Counselor · Broad Brook, CT
NPI 1336468032 · NPPES record last updated Apr 25, 2025
Key facts
- NPI
- 1336468032
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- 6113 (MA)
- Practice address
- 206 Canyon Ridge Dr
Broad Brook, CT 06016-9691 - Phone
- (860) 758-7861
- NPI assigned
- May 20, 2010
- Sex
- Male
- Sole proprietor
- Yes
Medicare Care Compare profile
- Specialty
- Mental Health Counselor
- Education
- Other, 2003
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2 Main St
Suite 2a
Plymouth, MA 02360-3329
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6113 | MA | MD | Mental Health Counselor |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6113 | MA | Yes |
Addresses
Primary practice location
206 Canyon Ridge Dr
Broad Brook, CT 06016-9691
Mailing address
206 Canyon Ridge Dr
Broad Brook, CT 06016-9691
Phone (860) 758-7861
Other practice location 1
11 River Street
Wellesley Hills, MA 02481-2017
Phone (781) 431-1177
Other providers in Broad Brook, CT
- Jessica Allard
- Christine Boucher
- Tanya Brooks
- Margaret Wood Carchrie
- Community Health Resources
- Erin Gately
- Krystle Janine George
- Ashantia Holiza Gordon
- Gordons Professional Care Services LLC
All providers in Broad Brook, CT · Mental Health Counselor in Connecticut
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 25, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.