Provider Demographics
NPI:1487811816
Name:CUADRA, MARIA ELISA (LCSWR CASAC CPP ACS)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ELISA
Last Name:CUADRA
Suffix:
Gender:F
Credentials:LCSWR CASAC CPP ACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 N STATION PLZ
Mailing Address - Street 2:COPAY INC,
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-5013
Mailing Address - Country:US
Mailing Address - Phone:516-466-2509
Mailing Address - Fax:516-482-3146
Practice Address - Street 1:21 N STATION PLZ
Practice Address - Street 2:COPAY INC,
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-5013
Practice Address - Country:US
Practice Address - Phone:516-466-2509
Practice Address - Fax:516-482-3146
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY692101Y00000X
NY8265101YA0400X
NYR-019119-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)