Provider Demographics
NPI:1740733880
Name:LUCCI, BREANNA MARIE (LMHC, LCMH & LADC-1)
Entity type:Individual
Prefix:
First Name:BREANNA
Middle Name:MARIE
Last Name:LUCCI
Suffix:
Gender:F
Credentials:LMHC, LCMH & LADC-1
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 SYLVAN ST FL 2A
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3581
Mailing Address - Country:US
Mailing Address - Phone:978-222-3121
Mailing Address - Fax:
Practice Address - Street 1:152 SYLVAN ST FL 2A
Practice Address - Street 2:
Practice Address - City:DANVERS
Practice Address - State:MA
Practice Address - Zip Code:01923-3581
Practice Address - Country:US
Practice Address - Phone:978-222-3121
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-25
Last Update Date:2024-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA18140101YA0400X
NC17541101YM0800X
MA11554101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)