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General NPI Number Information
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NPI Number | 1033067947
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Entity Type | Organization
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Legal Business Name | PUCCI LCSW, PLLC
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Dates
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Enumeration Date | 03/17/2026
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Last Update Date | 03/17/2026
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Provider Practice Location Address
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Address Line | 2312 DAMON RD.
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City | NEW WOODSTOCK
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State | NY
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Zip | 13122
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Country | US
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Telephone | 315-552-0315
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Fax |
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Provider Business Mailing Address
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Address Line | 248 ROUTE 25A STE 3056
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City | EAST SETAUKET
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State | NY
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Zip | 11733-2954
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Country | US
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Telephone | 315-552-0315
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Fax |
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Authorized Official
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Title or Position | MEMBER-MANAGER
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Name | PAMELA ANN PUCCI
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Credential | LCSW
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Telephone | 315-552-0315
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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