Provider Demographics
NPI:1598031049
Name:LITKEY, AMY DELUCA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:AMY
Middle Name:DELUCA
Last Name:LITKEY
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 1:24 LARCHMONT RD
Mailing Address - Street 2:
Mailing Address - City:EDISON
Mailing Address - State:NJ
Mailing Address - Zip Code:08837-2703
Mailing Address - Country:US
Mailing Address - Phone:732-816-5708
Mailing Address - Fax:
Practice Address - Street 1:24 LARCHMONT RD
Practice Address - Street 2:
Practice Address - City:EDISON
Practice Address - State:NJ
Practice Address - Zip Code:08837-2703
Practice Address - Country:US
Practice Address - Phone:732-816-5708
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-29
Last Update Date:2012-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC054338001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical