1578761920 NPI number — DEBORAH ANN DEL VECCHIO-SCULLY NCC, LPC

Table of content: DEBORAH ANN DEL VECCHIO-SCULLY NCC, LPC (NPI 1578761920)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1578761920 NPI number — DEBORAH ANN DEL VECCHIO-SCULLY NCC, LPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
DEL VECCHIO-SCULLY
Provider First Name:
DEBORAH
Provider Middle Name:
ANN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
NCC, LPC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DEL VECCHIO-SCULLY
Provider Other First Name:
DEBORAH
Provider Other Middle Name:
ANN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
LPC
Provider Other Last Name Type Code:
2

NPI Number Information

NPI Number:
1578761920
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/21/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
36 DORRANCE PL
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HAMDEN
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06518-3310
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-988-6769
Provider Business Mailing Address Fax Number:
203-248-5755

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
75 KINGS HIGHWAY CUTOFF
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FAIRFIELD
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06824-5340
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-331-1133
Provider Business Practice Location Address Fax Number:
203-333-3937
Provider Enumeration Date:
07/06/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X , with the licence number:  001565 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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