Provider Demographics
NPI:1023505203
Name:LUCCI, JOAN TERESSE (LPC)
Entity type:Individual
Prefix:
First Name:JOAN
Middle Name:TERESSE
Last Name:LUCCI
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 1:165 SENLAC HILLS DR
Mailing Address - Street 2:
Mailing Address - City:CHAGRIN FALLS
Mailing Address - State:OH
Mailing Address - Zip Code:44022-3254
Mailing Address - Country:US
Mailing Address - Phone:440-476-8321
Mailing Address - Fax:
Practice Address - Street 1:175 E ERIE ST STE 304
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:OH
Practice Address - Zip Code:44240-3595
Practice Address - Country:US
Practice Address - Phone:330-835-7477
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-13
Last Update Date:2018-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1200404101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health