Healthcare Provider Details

I. General information

NPI: 1477030633
Provider Name (Legal Business Name): CATHLEEN CODDING CSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/20/2018
Last Update Date: 07/20/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 WESTCOTT RD
DANIELSON CT
06239-2929
US

IV. Provider business mailing address

27 RANDOLPH RD
HOWELL NJ
07731-8611
US

V. Phone/Fax

Practice location:
  • Phone: 718-506-1115
  • Fax: 888-371-0842
Mailing address:
  • Phone: 972-677-7951
  • Fax: 888-371-0842

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: