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Individual

ANDREA PUCCIARELLO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MSW, LCSW

Contact information

Practice address
8058 DRY CREEK CIR, NIWOT, CO 80503-8598
(303) 524-0050
(720) 677-5532
Mailing address
8058 DRY CREEK CIR, NIWOT, CO 80503-8598
(303) 524-0050

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
1128
CO
1041C0700X
Clinical Social Worker
30739
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0026HV
BC BS OF TEXAS
TX
01
246101
COMPSYCH
01
503540
VALUE OPTIONS
05
9000147357
CO
01
9223591
PHCS
Enumeration date
08/30/2006
Last updated
03/28/2023
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