Doctor Name: | MS. BRIGITTE LYNN BUCCELLATO |
NPI Number: | 1053458224 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | 44SCC04790000 |
Business Practice Address: | 17-07 Romaine St Fair Lawn, NJ - 074102150 |
Business Phone Number: | 2017972660 |
Business Fax Number: | |
Mailing Address: | 312 Madison St Apt 2a, HOBOKEN |
State: | NJ |
Postal Code: | 070301925 |
Phone Number: | 2019139477 |
Fax Number: | |
NPI Enumeration Date: | 01/30/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | 44SCC04790000 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |