Provider Demographics
NPI:1881140853
Name:DILEONARDO, MADELEINE (MED, LPC)
Entity type:Individual
Prefix:
First Name:MADELEINE
Middle Name:
Last Name:DILEONARDO
Suffix:
Gender:F
Credentials:MED, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 LEES AVE STE 7-10
Mailing Address - Street 2:
Mailing Address - City:COLLINGSWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08108-2070
Mailing Address - Country:US
Mailing Address - Phone:856-240-0868
Mailing Address - Fax:
Practice Address - Street 1:2334 S BROAD ST
Practice Address - Street 2:APT B
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19145-4400
Practice Address - Country:US
Practice Address - Phone:609-519-1212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-08-30
Last Update Date:2020-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPC009127101YP2500X
NJ37PC00586600101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional