Healthcare Provider Details

I. General information

NPI: 1477415909
Provider Name (Legal Business Name): ALEXANDRIA E CIULLA LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/02/2025
Last Update Date: 12/02/2025
Certification Date: 12/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

389 MERRICK AVE
MERRICK NY
11566-2723
US

IV. Provider business mailing address

389 MERRICK AVE
MERRICK NY
11566-2723
US

V. Phone/Fax

Practice location:
  • Phone: 516-247-6449
  • Fax:
Mailing address:
  • Phone: 516-247-6449
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number017082
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: