Michael Rene De Leon, MA

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

204600 Issued in TX

Practice address

211 N Veterans Pkwy Ste 1
Bloomington, IL 61704-3568

Phone

(254) 294-6655

NPI assigned

Dec 26, 2023

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1703548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1760659200000",
    "number": "1962271403",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 N VETERANS PKWY STE 1",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043568",
            "telephone_number": "254-294-6655"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 N VETERANS PKWY STE 1",
            "city": "BLOOMINGTON",
            "state": "IL",
            "postal_code": "617043568",
            "telephone_number": "254-294-6655"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DE LEON",
        "first_name": "MICHAEL",
        "middle_name": "RENE",
        "credential": "MA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-12-26",
        "last_updated": "2025-10-17",
        "certification_date": "2025-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "TX",
            "license": "90221",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "IL",
            "license": "166.001929",
            "primary": false
        },
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "TX",
            "license": "204600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephanie L Davingman, CADC, LCSW, LMFT
• Francesca Lucia Davis
• Jacelle Davis
• Jessalyn Davis
• Dawn Zywiec Professional Counseling, LLC
• Gretchen Dean, PT
• James Stephen Decremer, LCPC
• Ibinabo Dede, MD
• Jacqueline Deffenbaugh, APN, WHNP
• Ronald Aurthur Degon, RSA, SA-C, CSA

• Marriage & Family Therapist in Bloomington, IL
• Providers in Bloomington, IL by specialty
• Marriage & Family Therapist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.