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General NPI Number Information
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NPI Number | 1255737573
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Entity Type | Individual
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Provider Name | MICHELLE MASSARINI LMHC
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Gender | Female
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Dates
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Enumeration Date | 11/13/2014
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Last Update Date | 03/17/2018
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Provider Practice Location Address
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Address Line | 6734 PINE RIDGE RD
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City | AUBURN
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State | NY
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Zip | 13021-8788
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Country | US
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Telephone | 315-253-4630
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Fax |
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Provider Business Mailing Address
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Address Line | 1462 LEVANNA RD
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City | UNION SPRINGS
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State | NY
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Zip | 13160-3196
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Country | US
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Telephone | 321-355-8355
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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 | 008331
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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