MEDICARE: MS. DENISE CORRADO LCSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	Q10000261	DE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1407840358
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DENISE CORRADO LCSW

Provider Business Mailing Address
First Line	:	820 FORKY FARM RD
Second Line	:
City	:	BRUCETON MILLS
State	:	WV
Zip	:	26525-6502
Country	:	US
Telephone Number	:	302-723-2855
Fax Number	:

Provider Business Practice Location Address
First Line	:	820 FORKY FARM RD
Second Line	:
City	:	BRUCETON MILLS
State	:	WV
Zip	:	26525-6502
Country	:	US
Telephone Number	:	302-723-2855
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/07/2005
Last Update Date	:	02/23/2022

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