Provider Demographics
NPI:1477912418
Name:PARADISO, MARIA C (LSW)
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:C
Last Name:PARADISO
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:915 OVERTON AVE
Mailing Address - Street 2:
Mailing Address - City:YARDLEY
Mailing Address - State:PA
Mailing Address - Zip Code:19067-1025
Mailing Address - Country:US
Mailing Address - Phone:610-349-4345
Mailing Address - Fax:
Practice Address - Street 1:915 OVERTON AVE
Practice Address - Street 2:
Practice Address - City:YARDLEY
Practice Address - State:PA
Practice Address - Zip Code:19067-1025
Practice Address - Country:US
Practice Address - Phone:610-349-4345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW128755104100000X
NY052492-1104100000X
NJ44SL05552800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker