Provider Demographics
NPI:1114277613
Name:VANELLA, LINDA (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:
Last Name:VANELLA
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:LINDA
Other - Middle Name:
Other - Last Name:VANELLA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LCSW-R
Mailing Address - Street 1:400 KINGS POINT DR APT 215
Mailing Address - Street 2:
Mailing Address - City:SUNNY ISLES BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33160-4732
Mailing Address - Country:US
Mailing Address - Phone:1631-793-3555
Mailing Address - Fax:786-463-1691
Practice Address - Street 1:119 W 57TH ST STE 1100
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-2401
Practice Address - Country:US
Practice Address - Phone:516-606-0811
Practice Address - Fax:786-463-1691
Is Sole Proprietor?:Yes
Enumeration Date:2012-09-12
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0453231041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical