Provider Demographics
NPI:1730735366
Name:LADO, MARISOL (MSW, DSW, LCSW)
Entity type:Individual
Prefix:DR
First Name:MARISOL
Middle Name:
Last Name:LADO
Suffix:
Gender:F
Credentials:MSW, DSW, LCSW
Other - Prefix:MRS
Other - First Name:BERTHA
Other - Middle Name:MARISOL
Other - Last Name:ROMERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW, LSW, LCSW
Mailing Address - Street 1:151 KNOLLCROFT RD # 116D
Mailing Address - Street 2:
Mailing Address - City:LYONS
Mailing Address - State:NJ
Mailing Address - Zip Code:07939-5001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:151 KNOLLCROFT RD # 116D
Practice Address - Street 2:
Practice Address - City:LYONS
Practice Address - State:NJ
Practice Address - Zip Code:07939-5001
Practice Address - Country:US
Practice Address - Phone:908-647-0180
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2023-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05629200104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker