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General NPI Number Information
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NPI Number | 1295227676
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Entity Type | Individual
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Provider Name | ALYSSA M AVILA MA, ATR
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Gender | Female
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Dates
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Enumeration Date | 06/01/2018
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Last Update Date | 02/09/2026
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Provider Practice Location Address
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Address Line | 1249 NOSTRAND AVE
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City | BROOKLYN
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State | NY
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Zip | 11225-3844
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Country | US
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Telephone | 718-765-6008
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Fax | 347-682-4219
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Provider Business Mailing Address
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Address Line | PO BOX 746087
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City | ATLANTA
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State | GA
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Zip | 30374-6087
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Country | US
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Telephone | 312-733-9730
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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 | 015166
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License Number State | NY
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