MEDICARE: MUCELLA ROSE LMHC-D, LPC,M.A,ME.D

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	017383	NY
2	101YM0800X	Mental Health Counselor	37PC01260400	NJ

General Provider Information

NPI Number	:	1477326502
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MUCELLA ROSE LMHC-D, LPC,M.A,ME.D

Provider Business Mailing Address
First Line	:	221 RIVER STREET, 9TH FLOOR
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030
Country	:	US
Telephone Number	:	646-941-7645
Fax Number	:

Provider Business Practice Location Address
First Line	:	221 RIVER STREET, 9TH FLOOR
Second Line	:
City	:	HOBOKEN
State	:	NJ
Zip	:	07030
Country	:	US
Telephone Number	:	646-941-7645
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/31/2023
Last Update Date	:	06/05/2026

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