Provider Demographics
NPI:1215173455
Name:MOREJON, MARIA (LMSW)
Entity type:Individual
Prefix:MS
First Name:MARIA
Middle Name:
Last Name:MOREJON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 LOCUST AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-3105
Mailing Address - Country:US
Mailing Address - Phone:718-979-7289
Mailing Address - Fax:
Practice Address - Street 1:147 LOCUST AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-3105
Practice Address - Country:US
Practice Address - Phone:718-979-7289
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-17
Last Update Date:2008-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY045271104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker