Provider Demographics
NPI:1497370928
Name:PANARIELLO, MICHAELA ALEXIS (LMHC)
Entity Type:Individual
Prefix:
First Name:MICHAELA
Middle Name:ALEXIS
Last Name:PANARIELLO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5301 N FEDERAL HWY STE 370
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33487-4910
Mailing Address - Country:US
Mailing Address - Phone:561-404-7625
Mailing Address - Fax:
Practice Address - Street 1:5301 N FEDERAL HWY STE 370
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33487-4910
Practice Address - Country:US
Practice Address - Phone:561-404-7625
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-10
Last Update Date:2020-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL17010101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health