Provider Demographics
NPI:1851894992
Name:VELLA, CARIE MARIE (LLMSW)
Entity Type:Individual
Prefix:
First Name:CARIE
Middle Name:MARIE
Last Name:VELLA
Suffix:
Gender:F
Credentials:LLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10000 MAYFIELD ST
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48150-5720
Mailing Address - Country:US
Mailing Address - Phone:313-817-5898
Mailing Address - Fax:
Practice Address - Street 1:8201 SYLVESTER ST
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48214-1131
Practice Address - Country:US
Practice Address - Phone:313-923-4200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-15
Last Update Date:2018-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI68010966321041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical