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General NPI Number Information
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NPI Number | 1295520906
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Entity Type | Individual
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Provider Name | CHANEL CHRISTINE MUCCI MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 04/12/2025
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Last Update Date | 04/12/2025
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Provider Practice Location Address
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Address Line | 1555 W SUNSET BLVD STE C
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City | LOS ANGELES
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State | CA
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Zip | 90026-7521
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Country | US
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Telephone | 323-388-3316
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Fax |
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Provider Business Mailing Address
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Address Line | 513 FAIR OAKS AVE APT F
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City | SOUTH PASADENA
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State | CA
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Zip | 91030-1840
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Country | US
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Telephone | 626-590-7458
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Fax |
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 154318
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License Number State | CA
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