Provider Demographics
NPI:1184170938
Name:DELEON, MADELIN (LMSW)
Entity type:Individual
Prefix:
First Name:MADELIN
Middle Name:
Last Name:DELEON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 WESTSIDE AVENUE
Mailing Address - Street 2:
Mailing Address - City:HAVERSTRAW
Mailing Address - State:NY
Mailing Address - Zip Code:10927
Mailing Address - Country:US
Mailing Address - Phone:845-596-8982
Mailing Address - Fax:
Practice Address - Street 1:99 MAIN ST
Practice Address - Street 2:SUITE 115
Practice Address - City:NYACK
Practice Address - State:NY
Practice Address - Zip Code:10960-3109
Practice Address - Country:US
Practice Address - Phone:845-596-8982
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-08-31
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY72-087290104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker