Provider Demographics
NPI:1770701815
Name:CUOMO, JOANNE (LCSW)
Entity type:Individual
Prefix:
First Name:JOANNE
Middle Name:
Last Name:CUOMO
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 1:60 VILLAGE GRN APT P
Mailing Address - Street 2:
Mailing Address - City:BUDD LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07828-1360
Mailing Address - Country:US
Mailing Address - Phone:973-229-0970
Mailing Address - Fax:908-979-1068
Practice Address - Street 1:254B MOUNTAIN AVE
Practice Address - Street 2:
Practice Address - City:HACKETTSTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07840-2413
Practice Address - Country:US
Practice Address - Phone:908-979-1144
Practice Address - Fax:908-979-1068
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC046595001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical