Provider Demographics
NPI:1114273505
Name:CARDILLO, MARIA ELANA (LPC)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:ELANA
Last Name:CARDILLO
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8739
Mailing Address - Street 2:
Mailing Address - City:BLACKWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08012-8739
Mailing Address - Country:US
Mailing Address - Phone:856-617-3552
Mailing Address - Fax:
Practice Address - Street 1:5 CAMELOT PL LOT OFFICE
Practice Address - Street 2:
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2308
Practice Address - Country:US
Practice Address - Phone:856-617-3552
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-03
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00454800101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor