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General NPI Number Information
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NPI Number | 1659093797
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Entity Type | Organization
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Legal Business Name | NICOLE CARROZZA PSYCHOLOGIST PLLC
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Dates
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Enumeration Date | 09/15/2022
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Last Update Date | 09/15/2022
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Provider Practice Location Address
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Address Line | 237 BEACH 122ND ST
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City | ROCKAWAY PARK
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State | NY
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Zip | 11694-2182
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Country | US
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Telephone | 347-422-6551
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Fax |
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Provider Business Mailing Address
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Address Line | 184 WOLVERINE ST
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City | STATEN ISLAND
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State | NY
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Zip | 10306-1744
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PSYCHOLOGIST
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Name | DR. NICOLE CARROZZA
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Credential | PSY.D
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Telephone | 347-422-6551
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TS0200X
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Taxonomy Name | School Psychologist
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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