Provider Demographics
NPI:1346363488
Name:KORDOWSKI, LISA J (MA, LPC)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:J
Last Name:KORDOWSKI
Suffix:
Gender:F
Credentials:MA, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:118 GUMSPRING RD
Mailing Address - Street 2:
Mailing Address - City:NEWARK
Mailing Address - State:DE
Mailing Address - Zip Code:19713-2919
Mailing Address - Country:US
Mailing Address - Phone:856-261-9741
Mailing Address - Fax:
Practice Address - Street 1:118 GUMSPRING RD
Practice Address - Street 2:
Practice Address - City:NEWARK
Practice Address - State:DE
Practice Address - Zip Code:19713-2919
Practice Address - Country:US
Practice Address - Phone:856-261-9741
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-06
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00065400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional