Provider Demographics
NPI:1942733993
Name:DELUCA, DENISE (LPCC)
Entity Type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:DELUCA
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33009 ALLENBURY DR
Mailing Address - Street 2:
Mailing Address - City:SOLON
Mailing Address - State:OH
Mailing Address - Zip Code:44139-6000
Mailing Address - Country:US
Mailing Address - Phone:440-409-3304
Mailing Address - Fax:
Practice Address - Street 1:28601 CHAGRIN BLVD STE 200
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:OH
Practice Address - Zip Code:44122-4556
Practice Address - Country:US
Practice Address - Phone:440-409-3304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-06
Last Update Date:2022-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHE.1901152101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0347591Medicaid