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NPI Code Detail

MEDICARE: MICHELLE COSTELLO LPCMH

MEDICARE:   MICHELLE  COSTELLO  LPCMH
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
1101YP2500XProfessional CounselorPC-0000733DE

General Provider Information

NPI Number : 1730548348
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE COSTELLO LPCMH
Provider Business Mailing Address
First Line : 240 N JAMES ST
Second Line : #104
City : WILMINGTON
State : DE
Zip : 19804-3169
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 240 N JAMES ST
Second Line : #104
City : WILMINGTON
State : DE
Zip : 19804-3169
Country : US
Telephone Number : 302-633-0301
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/11/2016
Last Update Date : 02/11/2016

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Directions to “ MICHELLE COSTELLO LPCMH” Practice Location

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