Provider Demographics
NPI:1629777024
Name:NELLI, LINDA (LMFT)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:NELLI
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3420 30TH ST APT 5F
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:NY
Mailing Address - Zip Code:11106-3065
Mailing Address - Country:US
Mailing Address - Phone:478-886-4934
Mailing Address - Fax:
Practice Address - Street 1:3420 30TH ST APT 5F
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11106-3065
Practice Address - Country:US
Practice Address - Phone:347-886-4934
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-02-24
Last Update Date:2023-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001053106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist