Provider Demographics
NPI:1316548266
Name:DE LEON PSYCHOTHERAPY & ASSESSMENTS
Entity Type:Organization
Organization Name:DE LEON PSYCHOTHERAPY & ASSESSMENTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ORLANDO
Authorized Official - Middle Name:FRANCO
Authorized Official - Last Name:DELEON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:512-714-2927
Mailing Address - Street 1:5750 BALCONES DR STE 117
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78731-4267
Mailing Address - Country:US
Mailing Address - Phone:512-714-2927
Mailing Address - Fax:888-497-1577
Practice Address - Street 1:5750 BALCONES DR STE 117
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78731-4267
Practice Address - Country:US
Practice Address - Phone:512-714-2927
Practice Address - Fax:888-497-1577
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-11-06
Last Update Date:2020-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX637573Medicaid