Provider Demographics
NPI:1437564192
Name:MANGIONE, LUCREZIA (LCPC,LPC,NCC,BC-TMH)
Entity Type:Individual
Prefix:MS
First Name:LUCREZIA
Middle Name:
Last Name:MANGIONE
Suffix:
Gender:F
Credentials:LCPC,LPC,NCC,BC-TMH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 CHRISTIAN ST
Mailing Address - Street 2:
Mailing Address - City:OXFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06478-1221
Mailing Address - Country:US
Mailing Address - Phone:802-578-3700
Mailing Address - Fax:
Practice Address - Street 1:160 CHRISTIAN ST
Practice Address - Street 2:
Practice Address - City:OXFORD
Practice Address - State:CT
Practice Address - Zip Code:06478-1221
Practice Address - Country:US
Practice Address - Phone:802-578-3700
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLC6046101YP2500X
VA0701008040101YP2500X
CT003752101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional