Provider Demographics
NPI:1104286608
Name:DELEON, ALEX
Entity type:Individual
Prefix:
First Name:ALEX
Middle Name:
Last Name:DELEON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:431 E LIVINGSTON AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43215-5533
Mailing Address - Country:US
Mailing Address - Phone:146-227-9420
Mailing Address - Fax:614-334-3234
Practice Address - Street 1:431 E LIVINGSTON AVE
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43215-5533
Practice Address - Country:US
Practice Address - Phone:146-227-9420
Practice Address - Fax:614-334-3234
Is Sole Proprietor?:No
Enumeration Date:2016-02-26
Last Update Date:2019-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No171M00000XOther Service ProvidersCase Manager/Care Coordinator