Provider Demographics
NPI:1568505147
Name:DELENO, WILLIAM J (LCSW)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:J
Last Name:DELENO
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 S BROADWAY
Mailing Address - Street 2:SUITE 600
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10601-4400
Mailing Address - Country:US
Mailing Address - Phone:914-328-9877
Mailing Address - Fax:914-328-9877
Practice Address - Street 1:34 S BROADWAY
Practice Address - Street 2:SUITE 600
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-4400
Practice Address - Country:US
Practice Address - Phone:914-328-9877
Practice Address - Fax:914-328-9877
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2012-11-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPRO20681-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01672375Medicaid
NYR47474Medicare UPIN
NYN28311Medicare ID - Type Unspecified