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General NPI Number Information
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NPI Number | 1942781612
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Entity Type | Individual
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Provider Name | PAMELA E LUCCI LICSW
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Gender | Female
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Dates
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Enumeration Date | 08/22/2018
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Last Update Date | 08/22/2018
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Provider Practice Location Address
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Address Line | 85 HERRICK ST
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City | BEVERLY
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State | MA
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Zip | 01915-1777
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Country | US
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Telephone | 978-816-2954
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Fax | 978-524-7917
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Provider Business Mailing Address
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Address Line | 21 HILLIS AVE
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City | WAKEFIELD
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State | MA
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Zip | 01880-3909
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Country | US
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Telephone | 781-789-4827
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number | 1029009
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License Number State | MA
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