# DELUCA FAMILY WELLNESS CENTER, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1174729990
- **Authorized official:** MR. MATTHEW JOSEPH DELUCA M.S. , LPC (MANAGING MEMBER)
- **Authorized official phone:** (304) 626-3541

## Contact information

- **Practice address:** RT. 2 BOX 406 SUITE 121, CLARKSBURG, WV 26301
- **Practice address phone:** (304) 626-3541
- **Practice address fax:** (304) 626-3174
- **Mailing address:** RT. 2 BOX 406 SUITE 121, CLARKSBURG, WV 26301
- **Mailing address phone:** (304) 626-3541
- **Mailing address fax:** (304) 626-3174

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YP2500X | Professional Counselor | 1540 | WV | Yes |

## Other

- **Enumeration date:** 06/27/2007
- **Last updated:** 01/01/2008

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 1540 | WV LPC | WV |