Provider Demographics
NPI:1215769054
Name:LIFE WITH A CUP OF JO LLC
Entity type:Organization
Organization Name:LIFE WITH A CUP OF JO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:JOCELYN
Authorized Official - Middle Name:G
Authorized Official - Last Name:CORDERO
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:808-343-2829
Mailing Address - Street 1:386 WALMART DR STE 7
Mailing Address - Street 2:PMB 18
Mailing Address - City:CAMDEN
Mailing Address - State:DE
Mailing Address - Zip Code:19934-1374
Mailing Address - Country:US
Mailing Address - Phone:808-343-2829
Mailing Address - Fax:833-804-2660
Practice Address - Street 1:39 NORTH WALNUT STREET
Practice Address - Street 2:SUITE 108
Practice Address - City:MILFORD
Practice Address - State:DE
Practice Address - Zip Code:19963-1467
Practice Address - Country:US
Practice Address - Phone:808-343-2829
Practice Address - Fax:833-804-2660
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LIFE WITH A CUP OF JO LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2024-08-19
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty
No251S00000XAgenciesCommunity/Behavioral Health