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General NPI Number Information
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NPI Number | 1821159161
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Entity Type | Individual
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Provider Name | MR. SALVATORE J LUCCA
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Gender | Male
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Dates
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Enumeration Date | 12/12/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 572 ROUTE 28 PARE & ASSOCIATES
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City | WEST YARMOUTH
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State | MA
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Zip | 02673-4909
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Country | US
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Telephone | 508-775-0777
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Fax |
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Provider Business Mailing Address
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Address Line | 12 WIDGEON LN
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City | WEST YARMOUTH
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State | MA
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Zip | 02673-3819
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Country | US
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Telephone | 508-776-9251
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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 | 217612
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License Number State | MA
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