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NPI Code Detail

MEDICARE: MICHEL ANTONIA SCALAMANDRE LMHC

MEDICARE: MICHEL ANTONIA SCALAMANDRE LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor011204-01NY

General Provider Information

NPI Number : 1366111981
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHEL ANTONIA SCALAMANDRE LMHC
Provider Business Mailing Address
First Line : 32 COMMODORE LN
Second Line :
City : WEST BABYLON
State : NY
Zip : 11704-8204
Country : US
Telephone Number : 151-665-8733
Fax Number :
Provider Business Practice Location Address
First Line : 799 DEER PARK AVE
Second Line :
City : NORTH BABYLON
State : NY
Zip : 11703-3812
Country : US
Telephone Number : 516-658-7330
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2021
Last Update Date : 09/08/2021

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