Provider Demographics
NPI:1841505849
Name:DELUCA - DIMARCO, JILL (LCSW)
Entity type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:DELUCA - DIMARCO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4036 ELLEN DR
Mailing Address - Street 2:
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-6222
Mailing Address - Country:US
Mailing Address - Phone:504-982-0237
Mailing Address - Fax:
Practice Address - Street 1:4036 ELLEN DR
Practice Address - Street 2:
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-6222
Practice Address - Country:US
Practice Address - Phone:504-982-0237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-13
Last Update Date:2014-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA42241041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical