Provider Demographics
NPI:1124562897
Name:MARTINELLI, ALICE (LCSW)
Entity Type:Individual
Prefix:
First Name:ALICE
Middle Name:
Last Name:MARTINELLI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3301 LANCASTER PIKE STE 5C
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19805-1436
Mailing Address - Country:US
Mailing Address - Phone:302-530-9109
Mailing Address - Fax:302-239-2493
Practice Address - Street 1:3301 LANCASTER PIKE STE 5C
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19805-1436
Practice Address - Country:US
Practice Address - Phone:302-530-9109
Practice Address - Fax:302-239-2493
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-14
Last Update Date:2016-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ1-00015081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical