Provider Demographics
NPI:1366689325
Name:CORDERO, MARIA LOURDES (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MARIA
Middle Name:LOURDES
Last Name:CORDERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:CORDERO
Other - Last Name:RUDDEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:100 MADISON AVENUE
Mailing Address - Street 2:CHILD DEVELOPMENT CENTER BOX 100 MORRISTOWN MEMORIAL HO
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07962-1956
Mailing Address - Country:US
Mailing Address - Phone:973-971-4208
Mailing Address - Fax:973-290-7164
Practice Address - Street 1:100 MADISON AVENUE
Practice Address - Street 2:CHILD DEVELOPMENT CENTER BOX 100 MORRISTOWN MEMORIAL HO
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07962-1956
Practice Address - Country:US
Practice Address - Phone:973-971-4208
Practice Address - Fax:973-290-7164
Is Sole Proprietor?:No
Enumeration Date:2009-01-13
Last Update Date:2009-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC049910001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical