Provider Demographics
NPI:1376372565
Name:NOVELLI-MILLER, RAINA (LPCA)
Entity type:Individual
Prefix:
First Name:RAINA
Middle Name:
Last Name:NOVELLI-MILLER
Suffix:
Gender:F
Credentials:LPCA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:335 ORANGE ST APT 305
Mailing Address - Street 2:
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06511-6494
Mailing Address - Country:US
Mailing Address - Phone:516-506-8345
Mailing Address - Fax:
Practice Address - Street 1:335 ORANGE ST APT 305
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-6494
Practice Address - Country:US
Practice Address - Phone:516-506-8345
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-29
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT5720101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health