Provider Demographics
NPI:1093337313
Name:MARCIANO, TINAMARIE (LCSW, LCADC)
Entity Type:Individual
Prefix:MRS
First Name:TINAMARIE
Middle Name:
Last Name:MARCIANO
Suffix:
Gender:F
Credentials:LCSW, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DUNCAN AVE
Mailing Address - Street 2:
Mailing Address - City:PEQUANNOCK
Mailing Address - State:NJ
Mailing Address - Zip Code:07440-1811
Mailing Address - Country:US
Mailing Address - Phone:973-452-3900
Mailing Address - Fax:
Practice Address - Street 1:23 DIAMOND SPRING RD STE 8
Practice Address - Street 2:
Practice Address - City:DENVILLE
Practice Address - State:NJ
Practice Address - Zip Code:07834-2750
Practice Address - Country:US
Practice Address - Phone:973-452-3900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-05-08
Last Update Date:2020-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00276000101YA0400X
NJ44SC059045001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)