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General NPI Number Information
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NPI Number | 1790181865
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Entity Type | Individual
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Provider Name | JOSHUA M ZELLO LPC-MHSP
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Gender | Male
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Dates
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Enumeration Date | 11/17/2014
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Last Update Date | 03/23/2016
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Provider Practice Location Address
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Address Line | 225 2ND ST NW
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City | CLEVELAND
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State | TN
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Zip | 37311
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Country | US
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Telephone | 423-310-8206
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 2224
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City | CLEVELAND
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State | TN
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Zip | 37320-2224
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Country | US
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Telephone | 423-310-8206
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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 | LPC0000003039
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License Number State | TN
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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 | LPC0000003039
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License Number State | TN
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