Healthcare Provider Details

I. General information

NPI: 1184541864
Provider Name (Legal Business Name): S CORDOVA COUNSELING SERVICES LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2026
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 STANLEY CIR STE 11
LATHAM NY
12110-2606
US

IV. Provider business mailing address

1045 BEVERLY ST
SCHENECTADY NY
12306-3746
US

V. Phone/Fax

Practice location:
  • Phone: 518-328-1889
  • Fax:
Mailing address:
  • Phone: 518-328-1889
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: SANDRA CORDOVA
Title or Position: OWNER
Credential: LCSW
Phone: 518-328-1889