Provider Demographics
NPI:1558511238
Name:CIUCCI, STEPHEN (LPC)
Entity Type:Individual
Prefix:MR
First Name:STEPHEN
Middle Name:
Last Name:CIUCCI
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SUMMIT RD
Mailing Address - Street 2:SUITE L
Mailing Address - City:PROSPECT
Mailing Address - State:CT
Mailing Address - Zip Code:06712-1426
Mailing Address - Country:US
Mailing Address - Phone:203-758-3570
Mailing Address - Fax:
Practice Address - Street 1:2 SUMMIT RD
Practice Address - Street 2:SUITE L
Practice Address - City:PROSPECT
Practice Address - State:CT
Practice Address - Zip Code:06712-1426
Practice Address - Country:US
Practice Address - Phone:203-758-3522
Practice Address - Fax:203-758-3522
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2011-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001625101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional