Provider Demographics
NPI:1821773284
Name:DELUCIA, CLEMENTINA (LMSW)
Entity Type:Individual
Prefix:
First Name:CLEMENTINA
Middle Name:
Last Name:DELUCIA
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 1:550 ELM ST
Mailing Address - Street 2:
Mailing Address - City:NORTH HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06473-3285
Mailing Address - Country:US
Mailing Address - Phone:203-410-1378
Mailing Address - Fax:
Practice Address - Street 1:255 BANK ST
Practice Address - Street 2:
Practice Address - City:WATERBURY
Practice Address - State:CT
Practice Address - Zip Code:06702-2236
Practice Address - Country:US
Practice Address - Phone:860-224-8192
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-21
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT6635104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker