Provider Demographics
NPI:1477892602
Name:DELEON, JAMISON (LICSW, LCSW-C, LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAMISON
Middle Name:
Last Name:DELEON
Suffix:
Gender:M
Credentials:LICSW, LCSW-C, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2639 CONNECTICUT AVE NW
Mailing Address - Street 2:SUITE 251
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20008-1537
Mailing Address - Country:US
Mailing Address - Phone:877-674-2843
Mailing Address - Fax:877-674-2843
Practice Address - Street 1:2639 CONNECTICUT AVE NW
Practice Address - Street 2:SUITE 251
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20008-1537
Practice Address - Country:US
Practice Address - Phone:877-674-2843
Practice Address - Fax:877-674-2843
Is Sole Proprietor?:No
Enumeration Date:2013-02-07
Last Update Date:2017-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040099301041C0700X
MD182831041C0700X
DCLC500802681041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical