Provider Demographics
NPI:1134337694
Name:CORMAN, LIZETTE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LIZETTE
Middle Name:
Last Name:CORMAN
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 1:737 LOTUS AVE
Mailing Address - Street 2:
Mailing Address - City:ORADELL
Mailing Address - State:NJ
Mailing Address - Zip Code:07649-1417
Mailing Address - Country:US
Mailing Address - Phone:201-965-7219
Mailing Address - Fax:201-261-8064
Practice Address - Street 1:19 WEST 34 ST.
Practice Address - Street 2:PENTHOUSE
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10001-1415
Practice Address - Country:US
Practice Address - Phone:201-965-7219
Practice Address - Fax:201-261-8064
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-18
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027393R1041C0700X
NJ44SC007670001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical