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General NPI Number Information
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NPI Number | 1245644715
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Entity Type | Individual
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Provider Name | MARY R CAROSELLI LMFT
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Gender | Female
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Dates
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Enumeration Date | 06/12/2014
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Last Update Date | 04/15/2024
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Provider Practice Location Address
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Address Line | 590 NAAMANS RD
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City | CLAYMONT
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State | DE
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Zip | 19703-2308
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Country | US
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Telephone | 302-545-5203
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Fax |
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Provider Business Mailing Address
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Address Line | 407 MEADOW LN
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City | MIDDLETOWN
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State | DE
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Zip | 19709-9693
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Country | US
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Telephone | 302-379-2659
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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 | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | FT-0000035
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License Number State | DE
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