Provider Demographics
NPI:1720809213
Name:DELEON, LUIS (LCSW)
Entity type:Individual
Prefix:
First Name:LUIS
Middle Name:
Last Name:DELEON
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:LUIS
Other - Middle Name:ALBERTO
Other - Last Name:DELEON
Other - Suffix:JR
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:7565 W TRAILS DR
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85308-2523
Mailing Address - Country:US
Mailing Address - Phone:646-240-8448
Mailing Address - Fax:
Practice Address - Street 1:7155 W CAMPO BELLO DR STE C120
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:AZ
Practice Address - Zip Code:85308-8594
Practice Address - Country:US
Practice Address - Phone:602-528-8148
Practice Address - Fax:480-247-4179
Is Sole Proprietor?:No
Enumeration Date:2024-10-18
Last Update Date:2024-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLCSW-225591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical