Provider Demographics
NPI:1407323520
Name:CELLA, CARRIE
Entity Type:Individual
Prefix:MS
First Name:CARRIE
Middle Name:
Last Name:CELLA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:414 HICKS ST APT A608
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11201-6689
Mailing Address - Country:US
Mailing Address - Phone:347-276-9765
Mailing Address - Fax:
Practice Address - Street 1:115 W 27TH ST FL 4
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-6217
Practice Address - Country:US
Practice Address - Phone:212-627-8181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-26
Last Update Date:2018-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079307-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker