Healthcare Provider Details

I. General information

NPI: 1053848937
Provider Name (Legal Business Name): MICHAEL TONUCCI LPC-A, BCBA, LBA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/22/2017
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19 MOUNTAIN TOP PASS
BURLINGTON CT
06013-2019
US

IV. Provider business mailing address

19 MOUNTAIN TOP PASS
BURLINGTON CT
06013-2019
US

V. Phone/Fax

Practice location:
  • Phone: 860-421-3244
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1-14-9876
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8533
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: