Provider Demographics
NPI:1699079657
Name:DI LUZIO, REBECCA A (LMSW)
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:A
Last Name:DI LUZIO
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 95000
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-4655
Mailing Address - Country:US
Mailing Address - Phone:800-444-6020
Mailing Address - Fax:845-256-1881
Practice Address - Street 1:16 E 16TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-3105
Practice Address - Country:US
Practice Address - Phone:212-206-5200
Practice Address - Fax:212-206-5279
Is Sole Proprietor?:No
Enumeration Date:2011-01-06
Last Update Date:2011-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082661104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker