Provider Demographics
NPI:1700208493
Name:DELEON, MARIA S (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:S
Last Name:DELEON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MRS
Other - First Name:MARIA
Other - Middle Name:S
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW
Mailing Address - Street 1:1810 CUYLER AVE
Mailing Address - Street 2:
Mailing Address - City:BERWYN
Mailing Address - State:IL
Mailing Address - Zip Code:60402-2052
Mailing Address - Country:US
Mailing Address - Phone:708-715-7071
Mailing Address - Fax:
Practice Address - Street 1:1810 CUYLER AVE
Practice Address - Street 2:
Practice Address - City:BERWYN
Practice Address - State:IL
Practice Address - Zip Code:60402-2052
Practice Address - Country:US
Practice Address - Phone:708-715-7071
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-14
Last Update Date:2014-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL149.0070091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical