Provider Demographics
NPI:1497910566
Name:JOSETTE M. LUCCI LLC
Entity Type:Organization
Organization Name:JOSETTE M. LUCCI LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MRS
Authorized Official - First Name:JOSETTE
Authorized Official - Middle Name:M
Authorized Official - Last Name:LUCCI
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:248-765-4550
Mailing Address - Street 1:1000 JOHN R RD STE 113
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48083-4317
Mailing Address - Country:US
Mailing Address - Phone:248-765-4550
Mailing Address - Fax:248-750-0807
Practice Address - Street 1:1000 JOHN R RD
Practice Address - Street 2:SUITE113
Practice Address - City:TROY
Practice Address - State:MI
Practice Address - Zip Code:48083-4317
Practice Address - Country:US
Practice Address - Phone:248-765-4550
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-28
Last Update Date:2023-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010670061041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty