Provider Demographics
NPI:1023902210
Name:CUCE, DEANDRA MARIE (LAC)
Entity type:Individual
Prefix:
First Name:DEANDRA
Middle Name:MARIE
Last Name:CUCE
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:116 VILLAGE BLVD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:NJ
Mailing Address - Zip Code:08540-5700
Mailing Address - Country:US
Mailing Address - Phone:732-703-7296
Mailing Address - Fax:
Practice Address - Street 1:116 VILLAGE BLVD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-5700
Practice Address - Country:US
Practice Address - Phone:732-703-7296
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-04
Last Update Date:2025-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00873100101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty