Provider Demographics
NPI:1962292128
Name:MANCINI, ANTONINA MICHELE (LCSW)
Entity type:Individual
Prefix:MS
First Name:ANTONINA
Middle Name:MICHELE
Last Name:MANCINI
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:NINA
Other - Middle Name:M
Other - Last Name:MANCINI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LCSW
Mailing Address - Street 1:625 CENTRAL AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06515-2168
Mailing Address - Country:US
Mailing Address - Phone:203-493-7369
Mailing Address - Fax:
Practice Address - Street 1:16 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:NAUGATUCK
Practice Address - State:CT
Practice Address - Zip Code:06770-4019
Practice Address - Country:US
Practice Address - Phone:203-493-7369
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-10
Last Update Date:2025-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT152341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical