Provider Demographics
NPI:1912251455
Name:CORREA, GLORIA M (MSW, LCSW)
Entity type:Individual
Prefix:MS
First Name:GLORIA
Middle Name:M
Last Name:CORREA
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:181 HOWARD BLVD STE J
Mailing Address - Street 2:
Mailing Address - City:MOUNT ARLINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07856-2314
Mailing Address - Country:US
Mailing Address - Phone:973-703-4642
Mailing Address - Fax:973-810-3010
Practice Address - Street 1:181 HOWARD BLVD STE J
Practice Address - Street 2:
Practice Address - City:MOUNT ARLINGTON
Practice Address - State:NJ
Practice Address - Zip Code:07856-2314
Practice Address - Country:US
Practice Address - Phone:973-703-4642
Practice Address - Fax:973-810-3010
Is Sole Proprietor?:Yes
Enumeration Date:2012-11-06
Last Update Date:2024-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL057890001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty