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1821113598 NPI number — JEFFREY JOSEPH COLUCCI PHD

NPI Number: 1821113598
Health Care Provider/Practitioner: JEFFREY JOSEPH COLUCCI PHD

Information about “1821113598” NPI (JEFFREY JOSEPH COLUCCI PHD) exists in 1821113598 in HTML format HTML  |  1821113598 in plain Text format TXT  |  1821113598 in PDF (Portable Document Format) PDF  |  1821113598 in an XML format XML  formats.

NPI Number : 1821113598 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1821113598",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "COLUCCI",
    "FirstName": "JEFFREY",
    "MiddleName": "JOSEPH",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "41 QUABOAG RD",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ACTON",
    "MailingAddressStateName": "MA",
    "MailingAddressPostalCode": "01720",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "978-263-1702",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "36 WOBURN ST",
    "SecondLinePracticeLocationAddress": "ACADEMY NORTH",
    "PracticeLocationAddressCityName": "READING",
    "PracticeLocationAddressStateName": "MA",
    "PracticeLocationAddressPostalCode": "01867",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "781-942-9277",
    "PracticeLocationAddressFaxNumber": "781-944-6535",
    "EnumerationDate": "03/20/2007",
    "LastUpdateDate": "09/11/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "103T00000X",
          "TaxonomyName": "Psychologist",
          "LicenseNumber": "3307",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TC2200X",
          "TaxonomyName": "Clinical Child & Adolescent Psychologist",
          "LicenseNumber": "3307",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "103TP2701X",
          "TaxonomyName": "Group Psychotherapy Psychologist",
          "LicenseNumber": "3307",
          "LicenseNumberStateCode": "MA",
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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