Provider Demographics
NPI:1376719393
Name:CADICAMO, MILDRED (MSW; LCSW)
Entity Type:Individual
Prefix:MS
First Name:MILDRED
Middle Name:
Last Name:CADICAMO
Suffix:
Gender:F
Credentials:MSW; LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 VICTORY RD
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-3717
Mailing Address - Country:US
Mailing Address - Phone:845-369-7762
Mailing Address - Fax:845-357-8709
Practice Address - Street 1:26 FIREMANS MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:POMONA
Practice Address - State:NY
Practice Address - Zip Code:10970-3553
Practice Address - Country:US
Practice Address - Phone:845-369-7762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR047230-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7427108OtherAETNA
NY274887000OtherMEGELLAN HEALTH SER VICES
NY3293238OtherAETNA