Provider Demographics
NPI:1326253659
Name:MANNUCCI, BARBARA C (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:C
Last Name:MANNUCCI
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 BROOK RUN DR.
Mailing Address - Street 2:
Mailing Address - City:EASTAMPTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08060-3202
Mailing Address - Country:US
Mailing Address - Phone:609-267-9175
Mailing Address - Fax:
Practice Address - Street 1:670 WOODBOURNE RD
Practice Address - Street 2:BLDG. #4
Practice Address - City:LANGHORNE
Practice Address - State:PA
Practice Address - Zip Code:19047-1847
Practice Address - Country:US
Practice Address - Phone:215-757-6916
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PACW014674101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA085148J9PMedicare ID - Type Unspecified