Provider Demographics
NPI:1457191827
Name:BUCCI, JESSICA A (MA LMHC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:A
Last Name:BUCCI
Suffix:
Gender:F
Credentials:MA LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 SETIAN LN
Mailing Address - Street 2:
Mailing Address - City:WEST WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02893-3224
Mailing Address - Country:US
Mailing Address - Phone:401-206-6233
Mailing Address - Fax:
Practice Address - Street 1:469 CENTERVILLE RD
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-4354
Practice Address - Country:US
Practice Address - Phone:401-206-6233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-31
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health