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General NPI Number Information
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NPI Number | 1053706671
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Entity Type | Individual
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Provider Name | DEANNA CUCCINELLO MA, LPCA, NCC
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Gender | Female
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Dates
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Enumeration Date | 03/31/2015
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Last Update Date | 07/01/2021
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Provider Practice Location Address
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Address Line | 121 ROLLING HILL RD STE 235
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City | MOORESVILLE
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State | NC
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Zip | 28117-8855
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Country | US
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Telephone | 828-548-0313
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Fax |
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Provider Business Mailing Address
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Address Line | 171 BAYBERRY CREEK CIR
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City | MOORESVILLE
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State | NC
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Zip | 28117-6690
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Country | US
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Telephone | 828-548-0313
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Fax | 704-660-6767
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | A11370
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License Number State | NC
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