Individual provider Active NPI

Mariann Rose Pello, PH.D.

  • Mental Health Counselor
  • Staten Island, NY
National Provider Identifier
1093098543
Registry record updated Sep 21, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
R 042989-1 Issued in NY
Practice address
1480 Forest Hill Rd
Staten Island, NY 10314-6318
Phone
(718) 698-2351
Fax
(718) 982-9044
NPI assigned
Sep 21, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 21, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X R 042989-1 NY Primary

Addresses

Primary practice location

1480 Forest Hill Rd
Staten Island, NY 10314-6318

Mailing address

1480 Forest Hill Rd
Staten Island, NY 10314-6318
Phone (718) 698-2351

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
R 042989-1NYMDMental Health Counselor

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1316563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1316563200000",
    "number": "1093098543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1480 FOREST HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146318",
            "telephone_number": "718-698-2351",
            "fax_number": "718-982-9044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1480 FOREST HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103146318",
            "telephone_number": "718-698-2351",
            "fax_number": "718-982-9044"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PELLO",
        "first_name": "MARIANN",
        "middle_name": "ROSE",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-09-21",
        "last_updated": "2011-09-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R 042989-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.