Active NPI
Mariann Rose Pello, PH.D.
- Mental Health Counselor
- Staten Island, NY
National Provider Identifier
1093098543
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- R 042989-1
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| R 042989-1 | NY | MD | Mental 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.