Healthcare Provider Details

I. General information

NPI: 1144838822
Provider Name (Legal Business Name): ARIELLE MANGANIELLO LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2020
Last Update Date: 09/08/2026
Certification Date: 09/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12625 HIGH BLUFF DR
SAN DIEGO CA
92130-2052
US

IV. Provider business mailing address

2000 W CHESTER PIKE
HAVERTOWN PA
19083-2713
US

V. Phone/Fax

Practice location:
  • Phone: 619-839-9422
  • Fax:
Mailing address:
  • Phone: 484-454-8700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberLPCC15253
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License NumberPC010741
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: