Provider Demographics
NPI:1407650021
Name:MINCER, LCSW, MIMI C
Entity type:Individual
Prefix:
First Name:MIMI
Middle Name:C
Last Name:MINCER, LCSW
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 ARNDT AVE APT A19
Mailing Address - Street 2:
Mailing Address - City:RIVERSIDE
Mailing Address - State:NJ
Mailing Address - Zip Code:08075-4230
Mailing Address - Country:US
Mailing Address - Phone:609-309-2777
Mailing Address - Fax:
Practice Address - Street 1:700 ARNDT AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:NJ
Practice Address - Zip Code:08075-4233
Practice Address - Country:US
Practice Address - Phone:609-309-2777
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-02
Last Update Date:2025-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC065371001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical