Provider Demographics
NPI:1841513785
Name:MOTTA, MARIELENA (MS, LCADC, LPC)
Entity type:Individual
Prefix:MS
First Name:MARIELENA
Middle Name:
Last Name:MOTTA
Suffix:
Gender:F
Credentials:MS, LCADC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1027
Mailing Address - Street 2:
Mailing Address - City:FLEMINGTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08822-1027
Mailing Address - Country:US
Mailing Address - Phone:732-667-5567
Mailing Address - Fax:732-667-5568
Practice Address - Street 1:56 MAIN ST STE 2B
Practice Address - Street 2:
Practice Address - City:FLEMINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08822-1474
Practice Address - Country:US
Practice Address - Phone:732-667-5567
Practice Address - Fax:732-667-5568
Is Sole Proprietor?:No
Enumeration Date:2010-03-07
Last Update Date:2021-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00419100101YM0800X
NJ37LC00151500101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health