Individual provider Active NPI

Breanna Marie Lucci, LMHC, LCMH & LADC-1

  • Mental Health Counselor
  • Danvers, MA
National Provider Identifier
1740733880
Registry record updated Jan 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
11554 Issued in MA
Practice address
152 Sylvan St FL 2a
Danvers, MA 01923-3581
Phone
(978) 222-3121
NPI assigned
Jul 25, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X 18140 MA
Mental Health Counselor 101YM0800X 17541 NC
Mental Health Counselor 101YM0800X 11554 MA Primary

Addresses

Primary practice location

152 Sylvan St FL 2a
Danvers, MA 01923-3581

Mailing address

152 Sylvan St FL 2a
Danvers, MA 01923-3581
Phone (978) 222-3121

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240125001092 MA Practitioner - Mental Health Counselor 5597118620 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
17541NCMDMental Health Counselor
18140MAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jan 28, 2024 Accepting new patients
Optum Behavioral Care of Connecticut, P.C. CurrentSince Jan 28, 2024 Accepting new patients

Locations

40 Shattuck Rd
Ste 250
Andover, MA 01810
Phone (603) 505-6847

140 Wood Rd
#206
Braintree, MA 02184

152 Sylvan St
Fl 2A
Danvers, MA 01923
Phone (603) 472-2846

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1469404800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705363200000",
    "number": "1740733880",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 SYLVAN ST FL 2A",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233581",
            "telephone_number": "978-222-3121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 SYLVAN ST FL 2A",
            "city": "DANVERS",
            "state": "MA",
            "postal_code": "019233581",
            "telephone_number": "978-222-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUCCI",
        "first_name": "BREANNA",
        "middle_name": "MARIE",
        "credential": "LMHC, LCMH & LADC-1",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-25",
        "last_updated": "2024-01-16",
        "certification_date": "2024-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "18140",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NC",
            "license": "17541",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "11554",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Danvers, MA

Sources for this page

Verify at the official NPI Registry.