Provider Demographics
NPI:1053706671
Name:CUCCINELLO, DEANNA (MA, LPCA, NCC)
Entity type:Individual
Prefix:MRS
First Name:DEANNA
Middle Name:
Last Name:CUCCINELLO
Suffix:
Gender:F
Credentials:MA, LPCA, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 BAYBERRY CREEK CIR
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-6690
Mailing Address - Country:US
Mailing Address - Phone:828-548-0313
Mailing Address - Fax:704-660-6767
Practice Address - Street 1:121 ROLLING HILL RD STE 235
Practice Address - Street 2:
Practice Address - City:MOORESVILLE
Practice Address - State:NC
Practice Address - Zip Code:28117-8855
Practice Address - Country:US
Practice Address - Phone:828-548-0313
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-31
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA11370101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional