Provider Demographics
NPI:1659023125
Name:K. DONELLI PSYCHOTHERAPY LICENSED MENTAL HEALTH COUNSELOR
Entity Type:Organization
Organization Name:K. DONELLI PSYCHOTHERAPY LICENSED MENTAL HEALTH COUNSELOR
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KERRY
Authorized Official - Middle Name:
Authorized Official - Last Name:DONELLI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:646-410-1151
Mailing Address - Street 1:1441 BROADWAY 5TH FLOOR
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10018
Mailing Address - Country:US
Mailing Address - Phone:646-410-1188
Mailing Address - Fax:646-844-7585
Practice Address - Street 1:1441 BROADWAY 5TH FLOOR
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10018
Practice Address - Country:US
Practice Address - Phone:646-410-1151
Practice Address - Fax:646-844-7585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-01-25
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty