Provider Demographics
NPI:1235147547
Name:DELGADO, MARIA (LMHC, LMSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:DELGADO
Suffix:
Gender:F
Credentials:LMHC, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N 5TH ST STE 2
Mailing Address - Street 2:
Mailing Address - City:FORT PIERCE
Mailing Address - State:FL
Mailing Address - Zip Code:34950-4266
Mailing Address - Country:US
Mailing Address - Phone:772-207-5390
Mailing Address - Fax:845-371-2255
Practice Address - Street 1:117 N 5TH ST STE 2
Practice Address - Street 2:
Practice Address - City:FORT PIERCE
Practice Address - State:FL
Practice Address - Zip Code:34950-4266
Practice Address - Country:US
Practice Address - Phone:772-207-5390
Practice Address - Fax:772-207-5390
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002529101Y00000X
NY0702961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY11614573OtherCAQH