Provider Demographics
NPI:1447429675
Name:LUCCHESI, PEGGY M (MA, LMHC)
Entity Type:Individual
Prefix:MS
First Name:PEGGY
Middle Name:M
Last Name:LUCCHESI
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:MS
Other - First Name:PEGGY
Other - Middle Name:M
Other - Last Name:LUCCHESI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA LMHC
Mailing Address - Street 1:4033 TILDEN LN
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CA
Mailing Address - Zip Code:94549-2737
Mailing Address - Country:US
Mailing Address - Phone:973-723-1488
Mailing Address - Fax:
Practice Address - Street 1:4033 TILDEN LN
Practice Address - Street 2:
Practice Address - City:LAFAYETTE
Practice Address - State:CA
Practice Address - Zip Code:94549-2737
Practice Address - Country:US
Practice Address - Phone:973-723-1488
Practice Address - Fax:973-723-1488
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-21
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY004107101YM0800X
CA1932101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health