Provider Demographics
NPI:1821525650
Name:BUCCOLA, VERONICA (LPC)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:
Last Name:BUCCOLA
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 BURGUIERES LN
Mailing Address - Street 2:
Mailing Address - City:DESTREHAN
Mailing Address - State:LA
Mailing Address - Zip Code:70047-5015
Mailing Address - Country:US
Mailing Address - Phone:504-821-2472
Mailing Address - Fax:504-522-0342
Practice Address - Street 1:1160 CAMP ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-4202
Practice Address - Country:US
Practice Address - Phone:504-821-2472
Practice Address - Fax:504-522-0342
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6112101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)