Provider Demographics
NPI:1124351317
Name:CORTELLESSA, TONI (LCSW-C)
Entity type:Individual
Prefix:
First Name:TONI
Middle Name:
Last Name:CORTELLESSA
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N WASHINGTON ST
Mailing Address - Street 2:STE 407
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-2223
Mailing Address - Country:US
Mailing Address - Phone:301-299-6470
Mailing Address - Fax:
Practice Address - Street 1:110 N WASHINGTON ST
Practice Address - Street 2:STE 407
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20850-2223
Practice Address - Country:US
Practice Address - Phone:301-299-6470
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-09-07
Last Update Date:2009-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC3021511041C0700X
MD072901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical