Provider Demographics
NPI:1649480476
Name:GIELLO, MARYANNE (LCSW)
Entity type:Individual
Prefix:MS
First Name:MARYANNE
Middle Name:
Last Name:GIELLO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2713 S BEULAH ST
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19148-5051
Mailing Address - Country:US
Mailing Address - Phone:856-854-5458
Mailing Address - Fax:856-854-5419
Practice Address - Street 1:20 IRVIN AVE
Practice Address - Street 2:2ND FLOOR
Practice Address - City:COLLINGSWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08108-3713
Practice Address - Country:US
Practice Address - Phone:856-854-5458
Practice Address - Fax:856-854-5419
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC 049091041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical