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General NPI Number Information
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NPI Number | 1417229659
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Entity Type | Individual
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Provider Name | AMY ANN VALLARELLI MS, LMHC, LCPC, NCC
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Gender | Female
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/25/2014
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Provider Practice Location Address
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Address Line | 1731 N MARCEY ST SUITE 535
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City | CHICAGO
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State | IL
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Zip | 60614-5373
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Country | US
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Telephone | 914-606-2566
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Fax |
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Provider Business Mailing Address
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Address Line | 2800 N LAKE SHORE DR APT 2015
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City | CHICAGO
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State | IL
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Zip | 60657-6247
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Country | US
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Telephone | 914-606-2566
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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 | 0050391
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 180008889
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License Number State | IL
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