Provider Demographics
NPI:1831702034
Name:STEPHANIE MAZZONI ENGLE, LCSW LLC
Entity type:Organization
Organization Name:STEPHANIE MAZZONI ENGLE, LCSW LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:SOLE PROPRIETOR
Authorized Official - Prefix:
Authorized Official - First Name:STEPHANIE
Authorized Official - Middle Name:MAZZONI
Authorized Official - Last Name:ENGLE
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:856-207-8966
Mailing Address - Street 1:1964 E OAK RD UNIT N1
Mailing Address - Street 2:
Mailing Address - City:VINELAND
Mailing Address - State:NJ
Mailing Address - Zip Code:08361-2584
Mailing Address - Country:US
Mailing Address - Phone:867-238-1044
Mailing Address - Fax:
Practice Address - Street 1:1964 E OAK RD UNIT N1
Practice Address - Street 2:
Practice Address - City:VINELAND
Practice Address - State:NJ
Practice Address - Zip Code:08361-2584
Practice Address - Country:US
Practice Address - Phone:867-238-1044
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-08-26
Last Update Date:2022-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty