Provider Demographics
NPI:1609596451
Name:MAINIERO, FELICIA (LCSW)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:MAINIERO
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 1:70 BRECKENRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-3266
Mailing Address - Country:US
Mailing Address - Phone:609-416-1276
Mailing Address - Fax:
Practice Address - Street 1:70 BRECKENRIDGE DR
Practice Address - Street 2:
Practice Address - City:SICKLERVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08081-3266
Practice Address - Country:US
Practice Address - Phone:609-416-1276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-31
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059338001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical