Provider Demographics
NPI:1972028710
Name:COCOROS, MARIA (PSYD, LGPC)
Entity Type:Individual
Prefix:DR
First Name:MARIA
Middle Name:
Last Name:COCOROS
Suffix:
Gender:F
Credentials:PSYD, LGPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6516 MONTROSE ST
Mailing Address - Street 2:
Mailing Address - City:ALEXANDRIA
Mailing Address - State:VA
Mailing Address - Zip Code:22312-2229
Mailing Address - Country:US
Mailing Address - Phone:240-370-8058
Mailing Address - Fax:
Practice Address - Street 1:3200 CRAIN HWY STE 203
Practice Address - Street 2:
Practice Address - City:WALDORF
Practice Address - State:MD
Practice Address - Zip Code:20603-4841
Practice Address - Country:US
Practice Address - Phone:240-370-8058
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-12
Last Update Date:2017-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDLGP7748101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health