Individual
MS. MICHELE IANNUCCI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPS, LCADC, LPC
Contact information
Practice address
14 SMULL AVE, CALDWELL, NJ 07006-5012
(973) 216-6815
Mailing address
128 HARVEST LN, LINCOLN PARK, NJ 07035-2045
(973) 216-6815
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
37PC00145200
NJ
101YA0400X
Addiction (Substance Use Disorder) Counselor
37LC00116000
NJ
Other
Enumeration date
11/13/2006
Last updated
09/11/2025
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