Provider Demographics
NPI:1548508195
Name:INFANTE-NEILL, ERICA A (MS, LPC)
Entity type:Individual
Prefix:
First Name:ERICA
Middle Name:A
Last Name:INFANTE-NEILL
Suffix:
Gender:F
Credentials:MS, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:107 COLBY AVE
Mailing Address - Street 2:
Mailing Address - City:MANASQUAN
Mailing Address - State:NJ
Mailing Address - Zip Code:08736-3002
Mailing Address - Country:US
Mailing Address - Phone:732-610-9387
Mailing Address - Fax:
Practice Address - Street 1:147 UNION AVE
Practice Address - Street 2:SUITE 202
Practice Address - City:MANASQUAN
Practice Address - State:NJ
Practice Address - Zip Code:08736-3648
Practice Address - Country:US
Practice Address - Phone:732-610-9387
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2016-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00467700101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional