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General NPI Number Information
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NPI Number | 1285453878
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Entity Type | Individual
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Provider Name | MIRNA JEANETH SCARPULLA MHC-LP
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Gender | Female
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 113 GLEN COVE AVE
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City | GLEN COVE
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State | NY
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Zip | 11542-3438
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Country | US
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Telephone | 516-622-8888
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Fax |
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Provider Business Mailing Address
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Address Line | 118 MAYFAIR AVE
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City | WEST HEMPSTEAD
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State | NY
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Zip | 11552-1514
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Country | US
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Telephone | 516-840-7448
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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 | P119582
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License Number State | NY
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