Provider Demographics
NPI:1548658248
Name:FELICE FASANO
Entity type:Organization
Organization Name:FELICE FASANO
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PROFESSIONAL COUNSELOR
Authorized Official - Prefix:
Authorized Official - First Name:FELICE
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:FASANO
Authorized Official - Suffix:
Authorized Official - Credentials:LPC
Authorized Official - Phone:732-873-7336
Mailing Address - Street 1:37 CHERRYWOOD DR
Mailing Address - Street 2:
Mailing Address - City:SOMERSET
Mailing Address - State:NJ
Mailing Address - Zip Code:08873-4235
Mailing Address - Country:US
Mailing Address - Phone:732-873-7336
Mailing Address - Fax:
Practice Address - Street 1:4499 ROUTE 27
Practice Address - Street 2:SUITE 3
Practice Address - City:PRINCETON
Practice Address - State:NJ
Practice Address - Zip Code:08540-8716
Practice Address - Country:US
Practice Address - Phone:609-285-3336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-01-03
Last Update Date:2015-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00470200101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty