Provider Demographics
NPI:1306554910
Name:DELA TORRE-MCILWAIN, HARLENE MACAPAGAL
Entity type:Individual
Prefix:
First Name:HARLENE
Middle Name:MACAPAGAL
Last Name:DELA TORRE-MCILWAIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:241 OCEAN PKWY APT D2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-3268
Mailing Address - Country:US
Mailing Address - Phone:601-460-9492
Mailing Address - Fax:
Practice Address - Street 1:241 OCEAN PKWY APT D2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11218-3268
Practice Address - Country:US
Practice Address - Phone:601-460-9492
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-11-11
Last Update Date:2022-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP118920101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health