Provider Demographics
NPI:1982457396
Name:DELUCA, SABRINA MARIE (LSW)
Entity Type:Individual
Prefix:
First Name:SABRINA
Middle Name:MARIE
Last Name:DELUCA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 SPRINGFIELD AVE APT I
Mailing Address - Street 2:
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-4061
Mailing Address - Country:US
Mailing Address - Phone:908-910-6262
Mailing Address - Fax:
Practice Address - Street 1:63 MILLTOWN RD
Practice Address - Street 2:
Practice Address - City:EAST BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08816-2378
Practice Address - Country:US
Practice Address - Phone:732-659-0683
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-08
Last Update Date:2024-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07056400104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker