Provider Demographics
NPI:1740558998
Name:DELGADO, JAVIER S (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JAVIER
Middle Name:S
Last Name:DELGADO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 LAWTON AVENUE
Mailing Address - Street 2:APARTMENT C-1
Mailing Address - City:CLIFFISDE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07010
Mailing Address - Country:US
Mailing Address - Phone:646-408-3978
Mailing Address - Fax:
Practice Address - Street 1:3940 BROADWAY
Practice Address - Street 2:SECOND FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-1534
Practice Address - Country:US
Practice Address - Phone:212-781-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-12-02
Last Update Date:2015-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY084580104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker