Provider Demographics
NPI:1528591757
Name:TERLECKY, DEANNA (LMSW)
Entity Type:Individual
Prefix:MS
First Name:DEANNA
Middle Name:
Last Name:TERLECKY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1269 NASH RD
Mailing Address - Street 2:
Mailing Address - City:NORTH TONAWANDA
Mailing Address - State:NY
Mailing Address - Zip Code:14120-2339
Mailing Address - Country:US
Mailing Address - Phone:716-278-8176
Mailing Address - Fax:
Practice Address - Street 1:1001 11TH ST.
Practice Address - Street 2:
Practice Address - City:NIAGARA FALLS
Practice Address - State:NY
Practice Address - Zip Code:14130-1201
Practice Address - Country:US
Practice Address - Phone:716-278-8176
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-05
Last Update Date:2017-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0997871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical