Individual
GINA M MANCUSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
181 HIGH ST, NUTLEY, NJ 07110-1176
(973) 945-4098
Mailing address
31 OAK LN, VERONA, NJ 07044-2233
(973) 857-1909
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
44SC05554400
NJ
Other
Enumeration date
02/09/2006
Last updated
03/21/2025
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