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NPI Code Detail

MEDICARE: AMANDA MARIE BUCCI LCPC-C

MEDICARE:   AMANDA MARIE BUCCI  LCPC-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YP2500XProfessional CounselorXL5660ME

General Provider Information

NPI Number : 1568061547
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA MARIE BUCCI LCPC-C
Provider Business Mailing Address
First Line : 19 SOUTH ST STE 6
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3963
Country : US
Telephone Number : 207-558-5539
Fax Number :
Provider Business Practice Location Address
First Line : 19 SOUTH ST STE 6
Second Line :
City : PORTLAND
State : ME
Zip : 04101-3963
Country : US
Telephone Number : 207-558-5539
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/21/2020
Last Update Date : 10/21/2020

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Directions to “ AMANDA MARIE BUCCI LCPC-C” Practice Location

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