Provider Demographics
NPI:1679399935
Name:MANFREDI, STEPHANIE (LCADC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:MANFREDI
Suffix:
Gender:F
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 DRUM POINT RD
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08723-6221
Mailing Address - Country:US
Mailing Address - Phone:732-278-9538
Mailing Address - Fax:
Practice Address - Street 1:121 DRUM POINT RD
Practice Address - Street 2:
Practice Address - City:BRICK
Practice Address - State:NJ
Practice Address - Zip Code:08723-6221
Practice Address - Country:US
Practice Address - Phone:732-278-9538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-02
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)