Healthcare Provider Details

I. General information

NPI: 1366877284
Provider Name (Legal Business Name): DANA MICHELLE CARRETTA LPC, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/10/2013
Last Update Date: 04/12/2023
Certification Date: 11/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

188 SUMMERFIELD ST STE 1
SCARSDALE NY
10583-5480
US

IV. Provider business mailing address

188 SUMMERFIELD ST STE 1
SCARSDALE NY
10583-5480
US

V. Phone/Fax

Practice location:
  • Phone: 914-222-3983
  • Fax:
Mailing address:
  • Phone: 914-222-3983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number005956-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number2314
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: