Provider Demographics
NPI:1457600850
Name:MALDONADO, ELGA (LMSW)
Entity Type:Individual
Prefix:
First Name:ELGA
Middle Name:
Last Name:MALDONADO
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 1:7 MARKET STREET
Mailing Address - Street 2:
Mailing Address - City:DOVER PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:12522-5136
Mailing Address - Country:US
Mailing Address - Phone:845-877-4100
Mailing Address - Fax:845-877-4112
Practice Address - Street 1:7 MARKET STREET
Practice Address - Street 2:
Practice Address - City:DOVER PLAINS
Practice Address - State:NY
Practice Address - Zip Code:12522-5136
Practice Address - Country:US
Practice Address - Phone:845-877-4100
Practice Address - Fax:845-877-4112
Is Sole Proprietor?:No
Enumeration Date:2012-08-31
Last Update Date:2012-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY086224-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical