Provider Demographics
NPI:1962780734
Name:GARRIEL, STEPHANIE MARIE (MSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:MARIE
Last Name:GARRIEL
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26 HONEYSUCKLE DR
Mailing Address - Street 2:
Mailing Address - City:SICKLERVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08081-4114
Mailing Address - Country:US
Mailing Address - Phone:856-603-0513
Mailing Address - Fax:
Practice Address - Street 1:1417 W OREGON AVE
Practice Address - Street 2:CATCH 2ND FL
Practice Address - City:PHILA
Practice Address - State:PA
Practice Address - Zip Code:19145-4926
Practice Address - Country:US
Practice Address - Phone:215-334-1311
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-28
Last Update Date:2011-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL05311000104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker