Active NPI
Marcellino Joseph Manganelli III, CERTIFIED SOCIAL WOR
- Social Worker
- Atlantic City, NJ
National Provider Identifier
1013346170
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 44SW00736700
- Practice address
- 2009 Bacharach Blvd
Atlantic City, NJ 08401-3003 - Phone
- (609) 344-5714
- Fax
- (609) 345-0775
- NPI assigned
- Nov 8, 2013
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37CA00100800 | NJ | |
| Social Worker | 104100000X | 44SW00736700 | NJ | Primary |
Addresses
Primary practice location
2009 Bacharach Blvd
Atlantic City, NJ 08401-3003
Mailing address
2009 Bacharach Blvd
Atlantic City, NJ 08401-3003
Phone (609) 344-5714
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37CA00100800 | NJ | MD | Addiction (Substance Use Disorder) Counselor |
| 44SW00736700 | NJ | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1383868800000",
"number": "1013346170",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2009 BACHARACH BLVD",
"city": "ATLANTIC CITY",
"state": "NJ",
"postal_code": "084013003",
"telephone_number": "609-344-5714",
"fax_number": "609-345-0775"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2009 BACHARACH BLVD",
"city": "ATLANTIC CITY",
"state": "NJ",
"postal_code": "084013003",
"telephone_number": "609-344-5714",
"fax_number": "609-345-0775"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANGANELLI",
"first_name": "MARCELLINO",
"middle_name": "JOSEPH",
"name_prefix": "Mr.",
"name_suffix": "III",
"credential": "CERTIFIED SOCIAL WOR",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-11-08",
"last_updated": "2013-11-08",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NJ",
"license": "37CA00100800",
"primary": false
},
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NJ",
"license": "44SW00736700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Atlantic City, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.