Provider Demographics
NPI:1720092174
Name:CUCCIA, CARMEN (LCSW)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:
Last Name:CUCCIA
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 COLBURN CT
Mailing Address - Street 2:
Mailing Address - City:WAYNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07470-8211
Mailing Address - Country:US
Mailing Address - Phone:973-696-5668
Mailing Address - Fax:073-305-8078
Practice Address - Street 1:11 COLBURN CT
Practice Address - Street 2:
Practice Address - City:WAYNE
Practice Address - State:NJ
Practice Address - Zip Code:07470-8211
Practice Address - Country:US
Practice Address - Phone:973-696-5668
Practice Address - Fax:073-305-8078
Is Sole Proprietor?:No
Enumeration Date:2006-07-28
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC474721041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical