=====================================================
General NPI Number Information
=====================================================
NPI Number | 1497532816
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | TUCCI COUNSELING & CONSULTING PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/11/2023
-----------------------------------------------------
Last Update Date | 09/11/2023
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1701 S 17TH ST STE 1A
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68502-2641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-570-2420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1701 S 17TH ST STE 1A
-----------------------------------------------------
City | LINCOLN
-----------------------------------------------------
State | NE
-----------------------------------------------------
Zip | 68502-2641
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 402-570-2420
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT/THERAPIST
-----------------------------------------------------
Name | JAMES P TUCCI
-----------------------------------------------------
Credential | MA, LIMHP
-----------------------------------------------------
Telephone | 402-570-2420
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 101YA0400X
-----------------------------------------------------
Taxonomy Name | Addiction (Substance Use Disorder) Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 101YM0800X
-----------------------------------------------------
Taxonomy Name | Mental Health Counselor
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------