Provider Demographics
NPI:1578763587
Name:BUCCI, AMANDA JEAN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMANDA
Middle Name:JEAN
Last Name:BUCCI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AMANDA
Other - Middle Name:JEAN
Other - Last Name:BUCCI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:91 ARTHUR RD
Mailing Address - Street 2:
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28806-1628
Mailing Address - Country:US
Mailing Address - Phone:828-582-6942
Mailing Address - Fax:828-552-5119
Practice Address - Street 1:12 RAVENSCROFT DR
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-3637
Practice Address - Country:US
Practice Address - Phone:828-582-6942
Practice Address - Fax:828-552-5119
Is Sole Proprietor?:No
Enumeration Date:2007-07-19
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0057461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC6106730Medicaid