Provider Demographics
NPI:1902395569
Name:MARIANO, ADRIENNE HARLEM (MA, LAC)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:HARLEM
Last Name:MARIANO
Suffix:
Gender:F
Credentials:MA, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94 DULLES DR
Mailing Address - Street 2:
Mailing Address - City:DUMONT
Mailing Address - State:NJ
Mailing Address - Zip Code:07628-3600
Mailing Address - Country:US
Mailing Address - Phone:908-803-6232
Mailing Address - Fax:
Practice Address - Street 1:94 DULLES DR
Practice Address - Street 2:
Practice Address - City:DUMONT
Practice Address - State:NJ
Practice Address - Zip Code:07628-3600
Practice Address - Country:US
Practice Address - Phone:908-803-6232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-08
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)