Provider Demographics
NPI:1922583137
Name:CARELLA, HEATHER (MA, LMHC, LPC, NCC)
Entity Type:Individual
Prefix:
First Name:HEATHER
Middle Name:
Last Name:CARELLA
Suffix:
Gender:F
Credentials:MA, LMHC, LPC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:577 NORMANDY VLG
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-6903
Mailing Address - Country:US
Mailing Address - Phone:716-417-4391
Mailing Address - Fax:
Practice Address - Street 1:70 HILLTOP RD STE 2350
Practice Address - Street 2:
Practice Address - City:RAMSEY
Practice Address - State:NJ
Practice Address - Zip Code:07446-1161
Practice Address - Country:US
Practice Address - Phone:732-982-2888
Practice Address - Fax:847-859-5885
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-03
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY37AC00419600101YM0800X
NY009455-1101YM0800X
NJ37PC00718400101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health