Provider Demographics
NPI:1417030719
Name:DE LEON, JUSTINE (LMSW)
Entity type:Individual
Prefix:
First Name:JUSTINE
Middle Name:
Last Name:DE LEON
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 1:18 OLD POST RD S
Mailing Address - Street 2:
Mailing Address - City:CROTON ON HUDSON
Mailing Address - State:NY
Mailing Address - Zip Code:10520-2316
Mailing Address - Country:US
Mailing Address - Phone:914-434-7607
Mailing Address - Fax:
Practice Address - Street 1:18 OLD POST RD S
Practice Address - Street 2:
Practice Address - City:CROTON ON HUDSON
Practice Address - State:NY
Practice Address - Zip Code:10520-2316
Practice Address - Country:US
Practice Address - Phone:914-434-7607
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-23
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY069262-11041C0700X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical