Provider Demographics
NPI:1619047883
Name:VECELLIO, NANCY E (LMHC, LSW)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:E
Last Name:VECELLIO
Suffix:
Gender:F
Credentials:LMHC, LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 HATHAWAY ST
Mailing Address - Street 2:
Mailing Address - City:NORTH ADAMS
Mailing Address - State:MA
Mailing Address - Zip Code:01247-2342
Mailing Address - Country:US
Mailing Address - Phone:413-662-2268
Mailing Address - Fax:
Practice Address - Street 1:25 MARSHALL ST
Practice Address - Street 2:BRIEN CENTER
Practice Address - City:NORTH ADAMS
Practice Address - State:MA
Practice Address - Zip Code:01247-2451
Practice Address - Country:US
Practice Address - Phone:413-664-4541
Practice Address - Fax:413-662-3311
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA970101YM0800X
MA3017680104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA33584OtherHEALTH NEW ENGLAND