Provider Demographics
NPI:1942928098
Name:DELUCA, ROUSZ (LMSW-LP)
Entity Type:Individual
Prefix:
First Name:ROUSZ
Middle Name:
Last Name:DELUCA
Suffix:
Gender:F
Credentials:LMSW-LP
Other - Prefix:
Other - First Name:CAROLINE
Other - Middle Name:ROSE
Other - Last Name:DELUCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:179 OCEAN PKWY APT 3C
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-2514
Mailing Address - Country:US
Mailing Address - Phone:347-878-3269
Mailing Address - Fax:
Practice Address - Street 1:175 E 94TH ST APT 1
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-2905
Practice Address - Country:US
Practice Address - Phone:917-674-3421
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-16
Last Update Date:2022-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP116832104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker