Provider Demographics
NPI:1154151223
Name:BUCCI, OLIVIA (LCSW)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:
Last Name:BUCCI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 E PUTNAM AVE STE 108
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06830-5408
Mailing Address - Country:US
Mailing Address - Phone:203-500-0886
Mailing Address - Fax:
Practice Address - Street 1:45 E PUTNAM AVE STE 108
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06830-5408
Practice Address - Country:US
Practice Address - Phone:203-500-0886
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-05
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT58.0142971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical