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General NPI Number Information
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NPI Number | 1023500378
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Entity Type | Individual
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Provider Name | MICHAEL VELLA LMHC
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Gender | Male
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Dates
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Enumeration Date | 06/02/2018
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Last Update Date | 06/02/2018
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Provider Practice Location Address
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Address Line | 153 W 27TH ST STE 300
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City | NEW YORK
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State | NY
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Zip | 10001-6259
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Country | US
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Telephone | 678-748-0430
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Fax |
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Provider Business Mailing Address
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Address Line | 47 BAY 10TH ST
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City | BROOKLYN
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State | NY
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Zip | 11228-3411
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Country | US
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Telephone | 917-969-1337
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 07674-1
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License Number State | NY
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