MEDICARE: MRS. SONIA MARTA PINERO LUCCI M.S., LPC

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
1	103TC0700X	Clinical Psychologist	5120-57	WI
2	101YA0400X	Addiction (Substance Use Disorder) Counselor	514929	WI

General Provider Information

NPI Number	:	1992137863
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. SONIA MARTA PINERO LUCCI M.S., LPC

Provider Business Mailing Address
First Line	:	6525 GREEN BAY RD STE 2
Second Line	:
City	:	KENOSHA
State	:	WI
Zip	:	53142-2967
Country	:	US
Telephone Number	:	262-999-3495
Fax Number	:	262-821-6180

Provider Business Practice Location Address
First Line	:	6525 GREEN BAY RD STE 2
Second Line	:
City	:	KENOSHA
State	:	WI
Zip	:	53142-2967
Country	:	US
Telephone Number	:	262-999-3495
Fax Number	:	262-821-6180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2013
Last Update Date	:	05/05/2026

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