Provider Demographics
NPI:1659566453
Name:LUCCI, MARIA JO (LMHC)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:JO
Last Name:LUCCI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:90 GRAY ST
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-1428
Mailing Address - Country:US
Mailing Address - Phone:480-209-5949
Mailing Address - Fax:
Practice Address - Street 1:555 MERRIMACK ST
Practice Address - Street 2:
Practice Address - City:LOWELL
Practice Address - State:MA
Practice Address - Zip Code:01854-3906
Practice Address - Country:US
Practice Address - Phone:978-459-8656
Practice Address - Fax:978-937-2559
Is Sole Proprietor?:No
Enumeration Date:2007-09-14
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA7674101YM0800X
101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)