1447429675 NPI number — MS. PEGGY M LUCCHESI M.A., L..M.H.C.

Table of content: MS. PEGGY M LUCCHESI M.A., L..M.H.C. (NPI 1447429675)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447429675 NPI number — MS. PEGGY M LUCCHESI M.A., L..M.H.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LUCCHESI
Provider First Name:
PEGGY
Provider Middle Name:
M
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M.A., L..M.H.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
LUCCHESI
Provider Other First Name:
PEGGY
Provider Other Middle Name:
M
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
MA LMHC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1447429675
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/23/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4033 TILDEN LN
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
LAFAYETTE
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
94549-2737
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
973-723-1488
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
4033 TILDEN LN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LAFAYETTE
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
94549-2737
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
973-723-1488
Provider Business Practice Location Address Fax Number:
973-723-1488
Provider Enumeration Date:
02/21/2008

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X , with the licence number:  004107 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YP2500X , with the licence number: 1932 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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