Provider Demographics
NPI:1417664194
Name:MUCCIO, ALESSANDRA (LCSW)
Entity Type:Individual
Prefix:
First Name:ALESSANDRA
Middle Name:
Last Name:MUCCIO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 PLEASANT ST # 9
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:02476-6535
Mailing Address - Country:US
Mailing Address - Phone:781-443-8344
Mailing Address - Fax:
Practice Address - Street 1:94 PLEASANT ST # 9
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:MA
Practice Address - Zip Code:02476-6535
Practice Address - Country:US
Practice Address - Phone:781-443-8344
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-01
Last Update Date:2022-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2268041041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical