Individual provider · Type 1 NPI

Summer B. Brancoccio, LAC, LCADC

Addiction (Substance Use Disorder) Counselor · Ridgewood, NJ

NPI number 1386993970 Active

Practice location

120 Chestnut Street
Ridgewood, NJ 07450

Mailing address

797 Edgewood Lane
Fort Lee, NJ 07024

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400X37LC00183400 (NJ)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1386993970

Summer B. Brancoccio, LAC, LCADC's National Provider Identifier is 1386993970, issued on Aug 29, 2012. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Ridgewood, NJ. The record was last updated on Aug 29, 2012.