Healthcare Provider Details

I. General information

NPI: 1427137116
Provider Name (Legal Business Name): THERESA A MAELIA LCSWR
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

370 VIOLET AVE
POUGHKEEPSIE NY
12601-1034
US

IV. Provider business mailing address

370 VIOLET AVE
POUGHKEEPSIE NY
12601-1034
US

V. Phone/Fax

Practice location:
  • Phone: 845-471-1807
  • Fax: 845-471-1815
Mailing address:
  • Phone: 845-471-1807
  • Fax: 845-471-1815

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number044622
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: