Provider Demographics
NPI:1285362954
Name:DELUCA, ROBYN S (PHD, MHC)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:S
Last Name:DELUCA
Suffix:
Gender:F
Credentials:PHD, MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:124 W 60TH ST APT 30B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7468
Mailing Address - Country:US
Mailing Address - Phone:631-942-9422
Mailing Address - Fax:
Practice Address - Street 1:15 W 84TH ST APT 1F
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-4704
Practice Address - Country:US
Practice Address - Phone:917-274-7196
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-10
Last Update Date:2022-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP117107101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health