Provider Demographics
NPI:1891371761
Name:SNEAD, MARINA (LSW)
Entity Type:Individual
Prefix:
First Name:MARINA
Middle Name:
Last Name:SNEAD
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 SEA BIRD LN
Mailing Address - Street 2:
Mailing Address - City:BELFORD
Mailing Address - State:NJ
Mailing Address - Zip Code:07718-1428
Mailing Address - Country:US
Mailing Address - Phone:347-417-0655
Mailing Address - Fax:
Practice Address - Street 1:145 SEA BIRD LN
Practice Address - Street 2:
Practice Address - City:BELFORD
Practice Address - State:NJ
Practice Address - Zip Code:07718-1428
Practice Address - Country:US
Practice Address - Phone:347-417-0655
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-22
Last Update Date:2021-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY111546104100000X
NJ44SL06591100104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker