Provider Demographics
NPI:1003315102
Name:MADELINE MALDONADO, LCSW CONSULTING P.C.
Entity Type:Organization
Organization Name:MADELINE MALDONADO, LCSW CONSULTING P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:MADELINE
Authorized Official - Middle Name:
Authorized Official - Last Name:MALDONADO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSWR
Authorized Official - Phone:917-880-8193
Mailing Address - Street 1:1160 MIDLAND AVENUE
Mailing Address - Street 2:APT 10G
Mailing Address - City:BRONXVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:10708-6428
Mailing Address - Country:US
Mailing Address - Phone:917-880-8193
Mailing Address - Fax:914-346-5031
Practice Address - Street 1:1160 MIDLAND AVENUE
Practice Address - Street 2:APT 10G
Practice Address - City:BRONXVILLE
Practice Address - State:NY
Practice Address - Zip Code:10708-6428
Practice Address - Country:US
Practice Address - Phone:917-880-8193
Practice Address - Fax:914-346-5031
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-02-05
Last Update Date:2022-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR062204-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYR062204-1OtherLICENSE NUMBER