Provider Demographics
NPI:1275016545
Name:DEJONG, MARGARET MAUREEN (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARGARET
Middle Name:MAUREEN
Last Name:DEJONG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 W 120TH ST APT 1A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-6482
Mailing Address - Country:US
Mailing Address - Phone:774-270-1346
Mailing Address - Fax:
Practice Address - Street 1:3 COLUMBUS CIR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-8760
Practice Address - Country:US
Practice Address - Phone:212-342-3800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-12
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0952951041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical