Basic Information
| Provider Information | |||||||||
| NPI: | 1134446081 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | DELEON | ||||||||
| FirstName: | PATRICK | ||||||||
| MiddleName: | DANIEL NAINOA | ||||||||
| NamePrefix: | |||||||||
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| Credential: | LCSW-C | ||||||||
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| Mailing Information | |||||||||
| Address1: | 9475 LOTTSFORD RD STE 250 | ||||||||
| Address2: | |||||||||
| City: | LARGO | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207745346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016366504 | ||||||||
| FaxNumber: | 3016366509 | ||||||||
| Practice Location | |||||||||
| Address1: | 9475 LOTTSFORD RD STE 250 | ||||||||
| Address2: | |||||||||
| City: | LARGO | ||||||||
| State: | MD | ||||||||
| PostalCode: | 207745346 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3016366504 | ||||||||
| FaxNumber: | 3016366509 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/30/2010 | ||||||||
| LastUpdateDate: | 04/30/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 1041C0700X | 15668 | MD | Y | Behavioral Health & Social Service Providers | Social Worker | Clinical |
No ID Information.