Provider Demographics
NPI:1831604362
Name:FUCCELLO, DANA ANN (LPC)
Entity type:Individual
Prefix:
First Name:DANA
Middle Name:ANN
Last Name:FUCCELLO
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 1:9071 MILL CREEK RD APT 2621
Mailing Address - Street 2:
Mailing Address - City:LEVITTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19054-4235
Mailing Address - Country:US
Mailing Address - Phone:215-535-9211
Mailing Address - Fax:
Practice Address - Street 1:9071 MILL CREEK RD
Practice Address - Street 2:
Practice Address - City:LEVITTOWN
Practice Address - State:PA
Practice Address - Zip Code:19054-4204
Practice Address - Country:US
Practice Address - Phone:267-831-3981
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-06
Last Update Date:2022-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00606000101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional