Provider Demographics
NPI:1174807879
Name:NATERA, STEPHANIE LUCIA (LCSW)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:LUCIA
Last Name:NATERA
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 HARKER AVE.
Mailing Address - Street 2:PO BOX 258
Mailing Address - City:BERLIN
Mailing Address - State:NJ
Mailing Address - Zip Code:08009-0258
Mailing Address - Country:US
Mailing Address - Phone:862-668-9649
Mailing Address - Fax:
Practice Address - Street 1:300 JOHNNY BOY LN
Practice Address - Street 2:
Practice Address - City:BERLIN
Practice Address - State:NJ
Practice Address - Zip Code:08009-2705
Practice Address - Country:US
Practice Address - Phone:862-668-9649
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-29
Last Update Date:2020-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC059310001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical