Healthcare Provider Details

I. General information

NPI: 1780528067
Provider Name (Legal Business Name): NINA MANCINI LCSW LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/16/2026
Last Update Date: 04/16/2026
Certification Date: 04/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 WARNER HILL RD UNIT 11
STRATFORD CT
06614-1431
US

IV. Provider business mailing address

125 WARNER HILL RD UNIT 11
STRATFORD CT
06614-1431
US

V. Phone/Fax

Practice location:
  • Phone: 203-494-1416
  • Fax:
Mailing address:
  • Phone: 203-494-1416
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. ANTONINA M MANCINI
Title or Position: PSYCHOTHERAPIST
Credential: LCSW
Phone: 203-494-1416