Provider Demographics
NPI:1114527934
Name:MINDFUL PROVERBS CONSULTATION LCSW, PLLC
Entity Type:Organization
Organization Name:MINDFUL PROVERBS CONSULTATION LCSW, PLLC
Other - Org Name:MINDFUL PROVERBS CONSULTATION LCSW, PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LATOYA
Authorized Official - Middle Name:ANGELA
Authorized Official - Last Name:DELMADGE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-514-4298
Mailing Address - Street 1:119 HOFFMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ELMONT
Mailing Address - State:NY
Mailing Address - Zip Code:11003-2905
Mailing Address - Country:US
Mailing Address - Phone:718-514-4298
Mailing Address - Fax:
Practice Address - Street 1:119 HOFFMAN AVE
Practice Address - Street 2:
Practice Address - City:ELMONT
Practice Address - State:NY
Practice Address - Zip Code:11003-2905
Practice Address - Country:US
Practice Address - Phone:718-514-4298
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-30
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty