Provider Demographics
NPI:1700607041
Name:MARINELLI, OLIVIA MARIE (LCSW)
Entity type:Individual
Prefix:
First Name:OLIVIA
Middle Name:MARIE
Last Name:MARINELLI
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 1:119 N WYOMING AVE
Mailing Address - Street 2:
Mailing Address - City:VENTNOR CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:08406-2054
Mailing Address - Country:US
Mailing Address - Phone:609-713-7448
Mailing Address - Fax:
Practice Address - Street 1:419 BETHEL RD STE A
Practice Address - Street 2:
Practice Address - City:SOMERS POINT
Practice Address - State:NJ
Practice Address - Zip Code:08244-2189
Practice Address - Country:US
Practice Address - Phone:609-788-4698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-21
Last Update Date:2024-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC057400001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical