Provider Demographics
NPI:1295077469
Name:COURTNEY, LORRAINE DELUCIA (LMSW)
Entity type:Individual
Prefix:MS
First Name:LORRAINE
Middle Name:DELUCIA
Last Name:COURTNEY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:LORRAINE
Other - Middle Name:FELICIA
Other - Last Name:DELUCIA-COURTNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMSW
Mailing Address - Street 1:1867 MOUNT HOPE AVE
Mailing Address - Street 2:VA HOMELESS PROGRAM
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14620-4540
Mailing Address - Country:US
Mailing Address - Phone:585-953-2276
Mailing Address - Fax:
Practice Address - Street 1:1867 MOUNT HOPE AVE
Practice Address - Street 2:VA HOMELESS PROGRAM
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14620-4540
Practice Address - Country:US
Practice Address - Phone:585-953-2276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-03-26
Last Update Date:2013-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72066448104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker