Provider Demographics
NPI:1124430897
Name:CUNHA, NOELLE (LSW)
Entity type:Individual
Prefix:
First Name:NOELLE
Middle Name:
Last Name:CUNHA
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 WILLOW BROOK RD
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-2810
Mailing Address - Country:US
Mailing Address - Phone:908-692-5611
Mailing Address - Fax:
Practice Address - Street 1:2667 NOTTINGHAM WAY
Practice Address - Street 2:SUITE 3
Practice Address - City:HAMILTON
Practice Address - State:NJ
Practice Address - Zip Code:08619-4116
Practice Address - Country:US
Practice Address - Phone:609-890-9998
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-05-28
Last Update Date:2014-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05167800104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker