Provider Demographics
NPI:1487733044
Name:LEBRON, MARIA (LCSW)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:LEBRON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1370 VIRGINIA AVE
Mailing Address - Street 2:#1E
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10462-7326
Mailing Address - Country:US
Mailing Address - Phone:917-446-2626
Mailing Address - Fax:
Practice Address - Street 1:481 8TH AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1809
Practice Address - Country:US
Practice Address - Phone:929-523-1610
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-03
Last Update Date:2020-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0827031041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty