Healthcare Provider Details

I. General information

NPI: 1962711093
Provider Name (Legal Business Name): NORMA A MORENO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/07/2010
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

127 UNION AVE STE 4
MIDDLESEX NJ
08846-1039
US

IV. Provider business mailing address

127 UNION AVE STE 4
MIDDLESEX NJ
08846-1039
US

V. Phone/Fax

Practice location:
  • Phone: 917-208-2582
  • Fax:
Mailing address:
  • Phone: 917-208-2582
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05884500
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number64601
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number085210
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: