Healthcare Provider Details

I. General information

NPI: 1952937047
Provider Name (Legal Business Name): RAFANNY MANGARELLI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/20/2020
Last Update Date: 12/10/2025
Certification Date: 12/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

311 CLAREMONT AVE
MONTCLAIR NJ
07042-2240
US

IV. Provider business mailing address

311 CLAREMONT AVE STE 2A
MONTCLAIR NJ
07042-2240
US

V. Phone/Fax

Practice location:
  • Phone: 862-245-1129
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC06280400
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: