Provider Demographics
NPI:1033799481
Name:MORELLI, MICHELE (MHC-LP, CRC)
Entity Type:Individual
Prefix:
First Name:MICHELE
Middle Name:
Last Name:MORELLI
Suffix:
Gender:F
Credentials:MHC-LP, CRC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1729 GORMLEY AVE
Mailing Address - Street 2:
Mailing Address - City:MERRICK
Mailing Address - State:NY
Mailing Address - Zip Code:11566-3007
Mailing Address - Country:US
Mailing Address - Phone:646-404-4323
Mailing Address - Fax:
Practice Address - Street 1:1729 GORMLEY AVE
Practice Address - Street 2:
Practice Address - City:MERRICK
Practice Address - State:NY
Practice Address - Zip Code:11566-3007
Practice Address - Country:US
Practice Address - Phone:646-404-4323
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-10
Last Update Date:2021-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP109160101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health