Provider Demographics
NPI:1184240434
Name:CELLA, ALYSSA (LMHC-LP, CASAC-T)
Entity type:Individual
Prefix:
First Name:ALYSSA
Middle Name:
Last Name:CELLA
Suffix:
Gender:F
Credentials:LMHC-LP, CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 SPRINGMEADOW DR UNIT I
Mailing Address - Street 2:
Mailing Address - City:HOLBROOK
Mailing Address - State:NY
Mailing Address - Zip Code:11741-4122
Mailing Address - Country:US
Mailing Address - Phone:516-318-5028
Mailing Address - Fax:
Practice Address - Street 1:217 SPRINGMEADOW DR UNIT I
Practice Address - Street 2:
Practice Address - City:HOLBROOK
Practice Address - State:NY
Practice Address - Zip Code:11741-4122
Practice Address - Country:US
Practice Address - Phone:516-318-5028
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-23
Last Update Date:2020-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP11187101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health