Provider Demographics
NPI:1629636485
Name:VICTORIA PATRELLO LLC
Entity Type:Organization
Organization Name:VICTORIA PATRELLO LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:VICTORIA
Authorized Official - Middle Name:ELYSE
Authorized Official - Last Name:RIOLA
Authorized Official - Suffix:
Authorized Official - Credentials:LISW-S
Authorized Official - Phone:914-438-3261
Mailing Address - Street 1:9810 RAVENNA RD STE 1
Mailing Address - Street 2:
Mailing Address - City:TWINSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:44087-1761
Mailing Address - Country:US
Mailing Address - Phone:330-331-2188
Mailing Address - Fax:330-331-2188
Practice Address - Street 1:9810 RAVENNA RD STE 1
Practice Address - Street 2:
Practice Address - City:TWINSBURG
Practice Address - State:OH
Practice Address - Zip Code:44087-1761
Practice Address - Country:US
Practice Address - Phone:330-331-2188
Practice Address - Fax:330-331-2188
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-06-05
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty