Provider Demographics
NPI:1235853136
Name:MANDEVILLA MENTAL HEALTH COUNSELING, PLLC
Entity Type:Organization
Organization Name:MANDEVILLA MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/LMHC
Authorized Official - Prefix:
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:NAPPI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:315-383-7151
Mailing Address - Street 1:810 OTTWAY RD
Mailing Address - Street 2:
Mailing Address - City:GREENEVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37745-8773
Mailing Address - Country:US
Mailing Address - Phone:315-383-7151
Mailing Address - Fax:315-800-6766
Practice Address - Street 1:605 W GENESEE ST STE 101
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13204-2344
Practice Address - Country:US
Practice Address - Phone:315-383-7151
Practice Address - Fax:315-800-6766
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-10-04
Last Update Date:2022-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1942883160OtherNPPES