MEDICARE: MICHELINA MARSICO-FELLMAN MA, ATR-BC, LPC

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	101YP2500X	Professional Counselor	PC016579	PA

General Provider Information

NPI Number	:	1851160105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHELINA MARSICO-FELLMAN MA, ATR-BC, LPC

Provider Business Mailing Address
First Line	:	4452 AUGUSTA DR
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-1517
Country	:	US
Telephone Number	:	717-329-9594
Fax Number	:

Provider Business Practice Location Address
First Line	:	1250 N MOUNTAIN RD STE 305
Second Line	:
City	:	HARRISBURG
State	:	PA
Zip	:	17112-1795
Country	:	US
Telephone Number	:	717-329-9594
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/28/2023
Last Update Date	:	03/18/2025

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