Provider Demographics
NPI:1922417468
Name:NOVELLA CONSULTATIONS, INC
Entity Type:Organization
Organization Name:NOVELLA CONSULTATIONS, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER/OWNER
Authorized Official - Prefix:MS
Authorized Official - First Name:CORINNE
Authorized Official - Middle Name:
Authorized Official - Last Name:NOVELLA
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:718-360-3156
Mailing Address - Street 1:174 15TH ST APT 6
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4830
Mailing Address - Country:US
Mailing Address - Phone:718-360-3156
Mailing Address - Fax:
Practice Address - Street 1:900 BROADWAY
Practice Address - Street 2:SUITE 403
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10003-1210
Practice Address - Country:US
Practice Address - Phone:718-360-3156
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY080258261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)