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General NPI Number Information
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NPI Number | 1629501440
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Entity Type | Individual
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Provider Name | MICHAEL ANTHONY BUCCHERI LPC, LCADC,NCC, CPRP
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Gender | Male
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Dates
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Enumeration Date | 04/08/2017
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Last Update Date | 01/20/2023
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Provider Practice Location Address
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Address Line | 615 HOPE RD BLDG 5B2
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City | EATONTOWN
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State | NJ
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Zip | 07724-1277
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Country | US
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Telephone | 732-389-0697
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Fax |
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Provider Business Mailing Address
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Address Line | 1319 GARVEN AVE
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City | OCEAN
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State | NJ
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Zip | 07712-4603
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Country | US
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Telephone | 732-673-8194
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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 | 37AC00347900
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00668400
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License Number State | NJ
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