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General NPI Number Information
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NPI Number | 1578280392
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Entity Type | Organization
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Legal Business Name | PELLOT MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 10/24/2022
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Last Update Date | 11/15/2022
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Provider Practice Location Address
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Address Line | 1714 HART ST
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City | RIDGEWOOD
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State | NY
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Zip | 11385-1144
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Country | US
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Telephone | 646-475-2368
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Fax |
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Provider Business Mailing Address
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Address Line | 6704 MYRTLE AVE
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City | GLENDALE
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State | NY
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Zip | 11385-7058
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Country | US
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Telephone | 646-475-2368
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Fax |
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Authorized Official
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Title or Position | LICENSED MENTAL HEALTH COUNSELOR
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Name | ORLANDO M PELLOT
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Credential | LMHC
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Telephone | 646-475-2368
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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 |
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License Number State |
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