Provider Demographics
NPI:1093469603
Name:ABBATIELLO, LOUIS JR (CADC)
Entity Type:Individual
Prefix:MR
First Name:LOUIS
Middle Name:
Last Name:ABBATIELLO
Suffix:JR
Gender:M
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1076 RT 47 SOUTH
Mailing Address - Street 2:
Mailing Address - City:RIO GRANDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08242
Mailing Address - Country:US
Mailing Address - Phone:609-741-6363
Mailing Address - Fax:609-939-4450
Practice Address - Street 1:1076 RT 47 SOUTH
Practice Address - Street 2:
Practice Address - City:RIO GRANDE
Practice Address - State:NJ
Practice Address - Zip Code:08242-1613
Practice Address - Country:US
Practice Address - Phone:609-741-6363
Practice Address - Fax:609-939-4450
Is Sole Proprietor?:No
Enumeration Date:2022-02-11
Last Update Date:2022-02-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37CA00155700101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)