Healthcare Provider Details

I. General information

NPI: 1942466628
Provider Name (Legal Business Name): MICHELLE SCOLARO MA, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/01/2008
Last Update Date: 08/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1938 ROUTE 6
CARMEL NY
10512-2311
US

IV. Provider business mailing address

1604 NUTMEG DR
CARMEL NY
10512-2659
US

V. Phone/Fax

Practice location:
  • Phone: 845-278-7272
  • Fax: 845-278-6905
Mailing address:
  • Phone: 914-474-6108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number000099
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: