Provider Demographics
NPI:1326296344
Name:PUCCI, PAMELA ANN (LCSW)
Entity type:Individual
Prefix:MISS
First Name:PAMELA
Middle Name:ANN
Last Name:PUCCI
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:PO BOX 73
Mailing Address - Street 2:
Mailing Address - City:NEW WOODSTOCK
Mailing Address - State:NY
Mailing Address - Zip Code:13122-0073
Mailing Address - Country:US
Mailing Address - Phone:607-244-9712
Mailing Address - Fax:
Practice Address - Street 1:5 COURT ST
Practice Address - Street 2:SUITE 42, COUNTY OFFICE BUILDING
Practice Address - City:NORWICH
Practice Address - State:NY
Practice Address - Zip Code:13815-1695
Practice Address - Country:US
Practice Address - Phone:607-337-1602
Practice Address - Fax:607-334-4519
Is Sole Proprietor?:No
Enumeration Date:2008-09-03
Last Update Date:2024-11-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092398-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical