Healthcare Provider Details

I. General information

NPI: 1609030659
Provider Name (Legal Business Name): DANIELLA POLIMENI LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DANIELLA TOZZI LCSW

II. Dates (important events)

Enumeration Date: 07/17/2008
Last Update Date: 01/13/2025
Certification Date: 01/13/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 HENRY ST
UNION BEACH NJ
07735-2642
US

IV. Provider business mailing address

202 HENRY ST
UNION BEACH NJ
07735-2642
US

V. Phone/Fax

Practice location:
  • Phone: 718-864-8722
  • Fax:
Mailing address:
  • Phone: 718-864-8722
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: