Provider Demographics
NPI:1164745212
Name:LOCICERO, DEBORAH LEE (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:DEBORAH
Middle Name:LEE
Last Name:LOCICERO
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:LEE
Other - Last Name:DESTEFANO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:2345 ROUTE 52
Mailing Address - Street 2:SUITE F
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-3218
Mailing Address - Country:US
Mailing Address - Phone:914-815-7271
Mailing Address - Fax:888-972-5017
Practice Address - Street 1:2345 ROUTE 52
Practice Address - Street 2:SUITE F
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-3218
Practice Address - Country:US
Practice Address - Phone:914-815-7271
Practice Address - Fax:888-972-5017
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-03
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR027894-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY6612266Medicaid