Provider Demographics
NPI:1417645599
Name:CEDDIA, MARIA R (LCSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:R
Last Name:CEDDIA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 BROADWAY STE 17&18
Mailing Address - Street 2:
Mailing Address - City:SAUGUS
Mailing Address - State:MA
Mailing Address - Zip Code:01906-1099
Mailing Address - Country:US
Mailing Address - Phone:781-233-1095
Mailing Address - Fax:781-233-1782
Practice Address - Street 1:184 BROADWAY STE 17&18
Practice Address - Street 2:
Practice Address - City:SAUGUS
Practice Address - State:MA
Practice Address - Zip Code:01906-1099
Practice Address - Country:US
Practice Address - Phone:781-233-1095
Practice Address - Fax:781-233-1782
Is Sole Proprietor?:No
Enumeration Date:2023-04-27
Last Update Date:2023-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MALCSW207585104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker