Provider Demographics
NPI:1144758095
Name:MATEO-DELHALL, DENICE (LMSW)
Entity Type:Individual
Prefix:
First Name:DENICE
Middle Name:
Last Name:MATEO-DELHALL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 KENT RD
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6040
Mailing Address - Country:US
Mailing Address - Phone:347-495-3902
Mailing Address - Fax:
Practice Address - Street 1:1156 N BROADWAY
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-1108
Practice Address - Country:US
Practice Address - Phone:914-965-3700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-23
Last Update Date:2018-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1285628552OtherAGENCY