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General NPI Number Information
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NPI Number | 1114805942
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Entity Type | Individual
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Provider Name | CARISSA FUCCI LPC
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Gender | Female
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Dates
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Enumeration Date | 08/21/2025
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Last Update Date | 08/21/2025
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Provider Practice Location Address
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Address Line | 262 CHESTNUT ST STE 100
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City | MEADVILLE
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State | PA
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Zip | 16335-3302
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Country | US
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Telephone | 814-332-0095
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Fax |
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Provider Business Mailing Address
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Address Line | 9072 LOJEK RD
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City | GUYS MILLS
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State | PA
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Zip | 16327-4124
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Country | US
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Telephone | 814-795-9351
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Fax | 814-746-3994
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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 | PC019110
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License Number State | PA
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