MEDICARE: VITALE MENTAL HEALTH COUNSELING PLLC

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
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1730895186
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	VITALE MENTAL HEALTH COUNSELING PLLC

Provider Business Mailing Address
First Line	:	21610 77TH AVE APT 6N
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-3443
Country	:	US
Telephone Number	:	917-892-0111
Fax Number	:

Provider Business Practice Location Address
First Line	:	21610 77TH AVE APT 6N
Second Line	:
City	:	OAKLAND GARDENS
State	:	NY
Zip	:	11364-3443
Country	:	US
Telephone Number	:	917-892-0111
Fax Number	:

Authorized Official
Title or Position	:	OWNER/ MENTAL HEALTH COUNSELOR
Name	:	MRS. ALEXANDRA VITALE
Credential	:	LMHC
Telephone Number	:	917-892-0111

Provider Enumeration Date	:	01/30/2023
Last Update Date	:	01/30/2023

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