Provider Demographics
NPI:1780812669
Name:CARELLA, JOSEPH D (PSYD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:D
Last Name:CARELLA
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5500 DR. MARTIN LUTHER KING STREET NORTH
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33703
Mailing Address - Country:US
Mailing Address - Phone:727-403-5473
Mailing Address - Fax:
Practice Address - Street 1:5500 DR MARTIN LUTHER KING ST N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33703-1204
Practice Address - Country:US
Practice Address - Phone:727-403-5473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-30
Last Update Date:2009-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPY5427103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical