Provider Demographics
NPI:1639781461
Name:MALDONADO-VELEZ, AERIAL (LCSW)
Entity Type:Individual
Prefix:
First Name:AERIAL
Middle Name:
Last Name:MALDONADO-VELEZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:AERIAL
Other - Middle Name:DAYSHA
Other - Last Name:AMOS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:120 APPLEBY ST NE
Mailing Address - Street 2:
Mailing Address - City:PALM BAY
Mailing Address - State:FL
Mailing Address - Zip Code:32907-3027
Mailing Address - Country:US
Mailing Address - Phone:910-624-2002
Mailing Address - Fax:
Practice Address - Street 1:257 BRODHEAD RD
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-8938
Practice Address - Country:US
Practice Address - Phone:484-822-5700
Practice Address - Fax:866-521-0526
Is Sole Proprietor?:No
Enumeration Date:2020-08-21
Last Update Date:2023-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX65965104100000X, 1041C0700X
FLSW19093101YM0800X, 1041C0700X
PACW0228181041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health