Provider Demographics
NPI:1841415262
Name:HERNANDEZ-GRECO, DOREEN MARIA (LCSW, LCADC)
Entity Type:Individual
Prefix:MS
First Name:DOREEN
Middle Name:MARIA
Last Name:HERNANDEZ-GRECO
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:450 ISLAND RD
Mailing Address - Street 2:UNIT #40
Mailing Address - City:RAMSEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07446-1144
Mailing Address - Country:US
Mailing Address - Phone:201-638-1586
Mailing Address - Fax:201-962-2543
Practice Address - Street 1:33-11 BROADWAY
Practice Address - Street 2:SUITE #202
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-4634
Practice Address - Country:US
Practice Address - Phone:201-638-1586
Practice Address - Fax:201-962-2543
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-13
Last Update Date:2008-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00068900101YA0400X
NJ44SC052949001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)