Provider Demographics
NPI:1275684623
Name:KARDOS, NINA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:NINA
Middle Name:
Last Name:KARDOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:
Other - Last Name:WOLDMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:300 S LENOLA RD
Mailing Address - Street 2:#224
Mailing Address - City:MAPLE SHADE
Mailing Address - State:NJ
Mailing Address - Zip Code:08052-3435
Mailing Address - Country:US
Mailing Address - Phone:856-220-3700
Mailing Address - Fax:856-424-9293
Practice Address - Street 1:1138 E CHESTNUT AVE
Practice Address - Street 2:BUILDING 6
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08360-5053
Practice Address - Country:US
Practice Address - Phone:856-220-3700
Practice Address - Fax:856-424-9293
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2007-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC007677001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ901470Medicare UPIN