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NPI Code Detail

MEDICARE: MS. MARIE A. ANTONUCCI LMHC

MEDICARE:  MS. MARIE A. ANTONUCCI  LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor52MA

General Provider Information

NPI Number : 1356425011
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. MARIE A. ANTONUCCI LMHC
Provider Business Mailing Address
First Line : 863 FRONT ST
Second Line :
City : WEYMOUTH
State : MA
Zip : 02190-1849
Country : US
Telephone Number : 781-337-7226
Fax Number :
Provider Business Practice Location Address
First Line : 12 HANCOCK CT
Second Line :
City : QUINCY
State : MA
Zip : 02169-5210
Country : US
Telephone Number : 617-769-7202
Fax Number : 617-770-1421
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/25/2006
Last Update Date : 07/08/2007

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Directions to “ MS. MARIE A. ANTONUCCI LMHC” Practice Location

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