Healthcare Provider Details

I. General information

NPI: 1447135140
Provider Name (Legal Business Name): EMILY COVELLO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 06/10/2026
Certification Date: 06/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6221 NY-31 SUITE 114B
CICERO NY
13039
US

IV. Provider business mailing address

118 FAIRWAY CIR
BALDWINSVILLE NY
13027-3359
US

V. Phone/Fax

Practice location:
  • Phone: 315-714-8255
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number016583
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number016583
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: