Provider Demographics
NPI:1396519252
Name:CARDELLO, LISA (EDS)
Entity type:Individual
Prefix:MS
First Name:LISA
Middle Name:
Last Name:CARDELLO
Suffix:
Gender:F
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:782 CARTERET CT
Mailing Address - Street 2:
Mailing Address - City:MOUNT LAUREL
Mailing Address - State:NJ
Mailing Address - Zip Code:08054-3205
Mailing Address - Country:US
Mailing Address - Phone:732-278-2821
Mailing Address - Fax:
Practice Address - Street 1:106 STRAUBE CENTER BLVD STE F-115
Practice Address - Street 2:
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-1497
Practice Address - Country:US
Practice Address - Phone:609-336-3012
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-11-10
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor