Provider Demographics
NPI:1346579661
Name:DICORCIA, DEANNA L (MA)
Entity Type:Individual
Prefix:MISS
First Name:DEANNA
Middle Name:L
Last Name:DICORCIA
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 BAYVIEW DR
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-7452
Mailing Address - Country:US
Mailing Address - Phone:732-927-0101
Mailing Address - Fax:
Practice Address - Street 1:95 BAYVIEW DR
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-7452
Practice Address - Country:US
Practice Address - Phone:732-927-0101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-12-16
Last Update Date:2017-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ1346579661OtherINSURANCES