Healthcare Provider Details

I. General information

NPI: 1992137863
Provider Name (Legal Business Name): SONIA MARTA PINERO LUCCI M.S., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2013
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6525 GREEN BAY RD STE 2
KENOSHA WI
53142-2967
US

IV. Provider business mailing address

6525 GREEN BAY RD STE 2
KENOSHA WI
53142-2967
US

V. Phone/Fax

Practice location:
  • Phone: 262-999-3495
  • Fax: 262-821-6180
Mailing address:
  • Phone: 262-999-3495
  • Fax: 262-821-6180

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number514929
License Number StateWI
# 2
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number5120-57
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: