Provider Demographics
NPI:1184198749
Name:MORENO, CLAUDIA LUCIA (PHD, LMSW)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:LUCIA
Last Name:MORENO
Suffix:
Gender:F
Credentials:PHD, LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8113 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5089
Mailing Address - Country:US
Mailing Address - Phone:201-233-0749
Mailing Address - Fax:201-624-8480
Practice Address - Street 1:8113 4TH AVE
Practice Address - Street 2:
Practice Address - City:NORTH BERGEN
Practice Address - State:NJ
Practice Address - Zip Code:07047-5089
Practice Address - Country:US
Practice Address - Phone:201-233-0749
Practice Address - Fax:201-624-8480
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-17
Last Update Date:2019-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SLO6165900104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker