Provider Demographics
NPI:1275993396
Name:MAURIELLO, NANCY ELLEN (MA,LPC)
Entity Type:Individual
Prefix:MS
First Name:NANCY
Middle Name:ELLEN
Last Name:MAURIELLO
Suffix:
Gender:F
Credentials:MA,LPC
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:
Other - Last Name:RYNO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:28 BOWLING GREEN PKWY STE LL3
Mailing Address - Street 2:
Mailing Address - City:LAKE HOPATCONG
Mailing Address - State:NJ
Mailing Address - Zip Code:07849-2445
Mailing Address - Country:US
Mailing Address - Phone:862-243-5241
Mailing Address - Fax:973-288-1028
Practice Address - Street 1:28 BOWLING GREEN PKWY STE LL3
Practice Address - Street 2:
Practice Address - City:LAKE HOPATCONG
Practice Address - State:NJ
Practice Address - Zip Code:07849-2445
Practice Address - Country:US
Practice Address - Phone:862-243-5241
Practice Address - Fax:973-288-1028
Is Sole Proprietor?:No
Enumeration Date:2016-03-02
Last Update Date:2018-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00540300101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional