Provider Demographics
NPI:1073950168
Name:DELGADO, MARILYN (MSW, LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARILYN
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:MARILYN
Other - Middle Name:
Other - Last Name:DELGADO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW, LCSW
Mailing Address - Street 1:2066 N WESTWIND DR
Mailing Address - Street 2:
Mailing Address - City:POST FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83854-8921
Mailing Address - Country:US
Mailing Address - Phone:208-819-3198
Mailing Address - Fax:
Practice Address - Street 1:2066 N WESTWIND DR
Practice Address - Street 2:
Practice Address - City:POST FALLS
Practice Address - State:ID
Practice Address - Zip Code:83854-8921
Practice Address - Country:US
Practice Address - Phone:208-819-3198
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-29
Last Update Date:2013-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDLCSW-326231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical