Provider Demographics
NPI:1518008028
Name:COLUCCI, JOHN JOSEPH (MA MED, LPC)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JOSEPH
Last Name:COLUCCI
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Gender:M
Credentials:MA MED, LPC
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Mailing Address - Street 1:95 MOUNT KEMBLE AVE
Mailing Address - Street 2:ATTN C LAMPRON
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-5155
Mailing Address - Country:US
Mailing Address - Phone:973-971-4714
Mailing Address - Fax:973-290-7585
Practice Address - Street 1:100 MADISON AVENUE
Practice Address - Street 2:MMH CIS BOX 97
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07962
Practice Address - Country:US
Practice Address - Phone:973-971-5402
Practice Address - Fax:973-971-5693
Is Sole Proprietor?:No
Enumeration Date:2007-02-08
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
NJ37PC00055500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional