Provider Demographics
NPI:1720418288
Name:LUCARELLI, KAELA
Entity Type:Individual
Prefix:
First Name:KAELA
Middle Name:
Last Name:LUCARELLI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1695 MAIN ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01103-1348
Mailing Address - Country:US
Mailing Address - Phone:339-225-2626
Mailing Address - Fax:
Practice Address - Street 1:1695 MAIN ST
Practice Address - Street 2:SUITE 300
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01103-1348
Practice Address - Country:US
Practice Address - Phone:339-225-2626
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-20
Last Update Date:2013-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor