Provider Demographics
NPI:1528561396
Name:CORDERO, JANETTE SALCEDO (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JANETTE
Middle Name:SALCEDO
Last Name:CORDERO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:JANETTE
Other - Middle Name:ELIZABETH
Other - Last Name:SALCEDO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4101 MEDICAL PKWY STE 109
Mailing Address - Street 2:
Mailing Address - City:AUSTIN
Mailing Address - State:TX
Mailing Address - Zip Code:78756-3724
Mailing Address - Country:US
Mailing Address - Phone:512-522-2067
Mailing Address - Fax:
Practice Address - Street 1:4101 MEDICAL PKWY STE 109
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78756-3724
Practice Address - Country:US
Practice Address - Phone:512-522-2067
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-17
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX566111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical