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General NPI Number Information
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NPI Number | 1013120955
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Entity Type | Individual
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Provider Name | MARIA DEOCA CORWIN PH.D LCSW
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Gender | Female
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Dates
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Enumeration Date | 05/07/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 410 FARNSWORTH AVE BORDENTOWN COUNSELING CENTER
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City | BORDENTOWN
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State | NJ
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Zip | 08505-2005
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Country | US
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Telephone | 609-298-9144
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Fax | 609-298-9288
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Provider Business Mailing Address
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Address Line | 14 WILLOW RD
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City | LAWRENCEVILLE
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State | NJ
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Zip | 08648-1620
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Country | US
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Telephone | 609-896-2738
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Fax | 609-896-0256
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 44SC01379300
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License Number State | NJ
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