Healthcare Provider Details

I. General information

NPI: 1750679320
Provider Name (Legal Business Name): MAYDELINE MORALES M.S
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2011
Last Update Date: 06/04/2026
Certification Date: 06/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

610 S HILLSIDE RD
WAPPINGERS FALLS NY
12590-6553
US

IV. Provider business mailing address

610 S HILLSIDE RD
WAPPINGERS FALLS NY
12590-6553
US

V. Phone/Fax

Practice location:
  • Phone: 646-245-0052
  • Fax: 845-592-2724
Mailing address:
  • Phone: 646-245-0052
  • Fax: 845-592-2724

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number719946
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: