Provider Demographics
NPI:1942393491
Name:VANINI, JOEL A (MSW LCSW)
Entity Type:Individual
Prefix:MS
First Name:JOEL
Middle Name:A
Last Name:VANINI
Suffix:
Gender:F
Credentials:MSW LCSW
Other - Prefix:
Other - First Name:JOEL
Other - Middle Name:VANINI
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MSW LCSW
Mailing Address - Street 1:32 BRIDGEVILLE RD
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:DE
Mailing Address - Zip Code:19947
Mailing Address - Country:US
Mailing Address - Phone:302-856-9190
Mailing Address - Fax:302-856-9133
Practice Address - Street 1:32 BRIDGEVILLE RD
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:DE
Practice Address - Zip Code:19947
Practice Address - Country:US
Practice Address - Phone:302-856-9190
Practice Address - Fax:302-856-9133
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2008-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEQ100002811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE1000032299Medicaid
DE00B059J11Medicare UPIN