Provider Demographics
NPI:1801846837
Name:LOCOCO, VICKI S (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:VICKI
Middle Name:S
Last Name:LOCOCO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:VICKI
Other - Middle Name:S
Other - Last Name:DOUECK LOCOCO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:336 W PASSAIC ST
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662-3027
Mailing Address - Country:US
Mailing Address - Phone:201-845-7030
Mailing Address - Fax:201-845-0899
Practice Address - Street 1:336 W PASSAIC ST
Practice Address - Street 2:2ND FLOOR
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3027
Practice Address - Country:US
Practice Address - Phone:201-845-7030
Practice Address - Fax:201-845-0899
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-11
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC005371001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN2T321Medicare ID - Type UnspecifiedPROVIDER NUMBER
NJ634527Medicare ID - Type UnspecifiedPROVIDER NUMBER