Healthcare Provider Details

I. General information

NPI: 1942117015
Provider Name (Legal Business Name): LINDA G LUCCHETTI LPC-A
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 ALDER ST
WATERBURY CT
06708-3507
US

IV. Provider business mailing address

100 ALDER ST
WATERBURY CT
06708-3507
US

V. Phone/Fax

Practice location:
  • Phone: 475-222-6123
  • Fax:
Mailing address:
  • Phone: 475-222-6123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10127
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: