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General NPI Number Information
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NPI Number | 1184145500
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Entity Type | Organization
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Legal Business Name | MARIA CORSO, LCSW, P.C.
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Dates
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Enumeration Date | 07/06/2017
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Last Update Date | 10/17/2024
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Provider Practice Location Address
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Address Line | 100 VETERANS BLVD
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City | MASSAPEQUA
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State | NY
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Zip | 11758-4944
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Country | US
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Telephone | 516-965-3454
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Fax |
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Provider Business Mailing Address
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Address Line | 2989 CHARLOTTE DR
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City | MERRICK
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State | NY
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Zip | 11566-5301
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Country | US
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Telephone | 516-965-3454
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Fax | 516-977-3404
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. MARIA CORSO
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Credential | LCSW-R
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Telephone | 516-965-3454
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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 | 080492
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License Number State | NY
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