Provider Demographics
NPI:1699221259
Name:TAMPELLINI, JOSEPH PETIYA (LMSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:PETIYA
Last Name:TAMPELLINI
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 HIGHMONT DR
Mailing Address - Street 2:
Mailing Address - City:WEST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08550-3523
Mailing Address - Country:US
Mailing Address - Phone:609-947-6990
Mailing Address - Fax:
Practice Address - Street 1:316 E 88TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-4909
Practice Address - Country:US
Practice Address - Phone:347-880-2875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-01
Last Update Date:2023-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1041C0700X
DCLG200002537104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical