Lisa C. Deluca, LCSW
Individual provider Active NPI Clinical Social Worker · Southold, NY
NPI 1669697397 · NPPES record last updated Nov 7, 2014
Key facts
- NPI
- 1669697397
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 082470-1 (NY)
- Practice address
- 53840 Main Road
Southold, NY 11971 - Phone
- (631) 903-4177
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 27, 2022 through Dec 27, 2026
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 082470-1 | NY | MD | Clinical Social Worker |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 082470-1 | NY | Yes |
Addresses
Primary practice location
53840 Main Road
Southold, NY 11971
Mailing address
175 The Crossways
East Marion, NY 11939-1007
Phone (631) 903-4177
Other providers in Southold, NY
- Saundra L Claud
- Helen M Cochran
- Rosemarie Febles Connolly
- Janice Marie Conover
- Lisa Beth Cowley
- Paul Anthony Depaulis
- Desiree I Reese LCSW PLLC
- Gary Despres
- Judith Devito
- James Andrew Dibble
All providers in Southold, NY · Clinical Social Worker in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 7, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Opt Out Affidavits (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.