Provider Demographics
NPI:1649762675
Name:NIEVES, MAYELIN DEL CARMEN (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MAYELIN
Middle Name:DEL CARMEN
Last Name:NIEVES
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 1:342 SEA PINE DR
Mailing Address - Street 2:
Mailing Address - City:EGG HARBOR TOWNSHIP
Mailing Address - State:NJ
Mailing Address - Zip Code:08234-8127
Mailing Address - Country:US
Mailing Address - Phone:609-246-1535
Mailing Address - Fax:
Practice Address - Street 1:1402 DOUGHTY RD STE 201
Practice Address - Street 2:
Practice Address - City:EGG HARBOR TOWNSHIP
Practice Address - State:NJ
Practice Address - Zip Code:08234-5640
Practice Address - Country:US
Practice Address - Phone:609-798-1488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-05
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057928001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical