Healthcare Provider Details

I. General information

NPI: 1083358386
Provider Name (Legal Business Name): COUNSELING ASSOCIATES OF DELAWARE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2022
Last Update Date: 04/22/2022
Certification Date: 04/22/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 W ROCKLAND RD STE K-1
MONTCHANIN DE
19710-2006
US

IV. Provider business mailing address

50 PASCHALL RD
WILMINGTON DE
19803-4944
US

V. Phone/Fax

Practice location:
  • Phone: 302-750-0672
  • Fax:
Mailing address:
  • Phone: 302-750-0672
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MS. AMY E. CARELLO
Title or Position: CO-OWNER/THERAPIST
Credential: LPCMH
Phone: 302-750-0672