Provider Demographics
NPI:1467882522
Name:DILIBERTO, STACY MARIE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:STACY
Middle Name:MARIE
Last Name:DILIBERTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6744
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70174-6744
Mailing Address - Country:US
Mailing Address - Phone:504-309-7844
Mailing Address - Fax:504-309-7845
Practice Address - Street 1:3196 TERRACE AVE
Practice Address - Street 2:
Practice Address - City:SLIDELL
Practice Address - State:LA
Practice Address - Zip Code:70458-4500
Practice Address - Country:US
Practice Address - Phone:985-788-7822
Practice Address - Fax:504-309-7845
Is Sole Proprietor?:No
Enumeration Date:2013-11-26
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA9492104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker