Provider Demographics
NPI:1598884256
Name:DELUCA, LUISA (MS, LCMHC)
Entity Type:Individual
Prefix:
First Name:LUISA
Middle Name:
Last Name:DELUCA
Suffix:
Gender:F
Credentials:MS, LCMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2843 S COUNTY TRL STE 101
Mailing Address - Street 2:
Mailing Address - City:EAST GREENWICH
Mailing Address - State:RI
Mailing Address - Zip Code:02818-1753
Mailing Address - Country:US
Mailing Address - Phone:401-398-7799
Mailing Address - Fax:401-398-7889
Practice Address - Street 1:2843 S COUNTY TRL STE 101
Practice Address - Street 2:
Practice Address - City:EAST GREENWICH
Practice Address - State:RI
Practice Address - Zip Code:02818-1753
Practice Address - Country:US
Practice Address - Phone:401-398-7799
Practice Address - Fax:401-398-7889
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2019-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMHC000079101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
RIMHC00079OtherSTATE LICENSE