| Doctor Name: | LISA C. DELUCA |
| NPI Number: | 1669697397 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 082470-1 |
| Business Practice Address: | 53840 Main Road Southold, NY - 11971 |
| Business Phone Number: | 6319034177 |
| Business Fax Number: | |
| Mailing Address: | 175 The Crossways, EAST MARION |
| State: | NY |
| Postal Code: | 119391007 |
| Phone Number: | 6319034177 |
| Fax Number: | |
| NPI Enumeration Date: | 04/16/2007 |
| NPI Last Update Date: | 11/07/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 082470-1 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |