Provider Demographics
NPI:1295967685
Name:PELLOT, ORLANDO M (MS, LMHC)
Entity type:Individual
Prefix:MR
First Name:ORLANDO
Middle Name:M
Last Name:PELLOT
Suffix:
Gender:M
Credentials:MS, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6704 MYRTLE AVE
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11385-7058
Mailing Address - Country:US
Mailing Address - Phone:718-635-9850
Mailing Address - Fax:
Practice Address - Street 1:1714 HART ST
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NY
Practice Address - Zip Code:11385-1144
Practice Address - Country:US
Practice Address - Phone:646-600-5018
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-18
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005211101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health