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General NPI Number Information
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NPI Number | 1013494335
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Entity Type | Individual
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Provider Name | ALBERT JAMES DELONEY IV LCSW
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Gender | Male
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Dates
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Enumeration Date | 07/20/2018
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Last Update Date | 11/11/2020
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Provider Practice Location Address
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Address Line | 1616 E 50TH PL APT 8D
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City | CHICAGO
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State | IL
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Zip | 60615-3111
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Country | US
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Telephone | 929-525-4357
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Fax |
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Provider Business Mailing Address
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Address Line | 8316 S MARYLAND AVE
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City | CHICAGO
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State | IL
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Zip | 60619-5912
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Country | US
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Telephone | 708-297-8703
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.019712
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License Number State | IL
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