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General NPI Number Information
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NPI Number | 1114277613
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Entity Type | Individual
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Provider Name | LINDA VANELLA LCSW-R
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Gender | Female
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Dates
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Enumeration Date | 09/12/2012
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 119 W 57TH ST STE 1100
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City | NEW YORK
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State | NY
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Zip | 10019-2401
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Country | US
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Telephone | 516-606-0811
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Fax | 786-463-1691
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Provider Business Mailing Address
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Address Line | 400 KINGS POINT DR APT 215
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City | SUNNY ISLES BEACH
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State | FL
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Zip | 33160-4732
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Country | US
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Telephone | 16317933555
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Fax | 786-463-1691
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 045323
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License Number State | NY
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