Active NPI
Mary Louise Alexia Inzerillo, LPC
- Professional Counselor
- Drexel Hill, PA
National Provider Identifier
1760962674
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Professional Counselor
- License
- PC00932
- Practice address
- 5060 State Rd FL 2
Drexel Hill, PA 19026-4609 - NPI assigned
- Aug 20, 2018
- Last updated
- Aug 20, 2018
- 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 |
|---|---|---|---|---|
| Professional Counselor | 101YP2500X | PC00932 | PA | Primary |
Addresses
Primary practice location
5060 State Rd FL 2
Drexel Hill, PA 19026-4609
Mailing address
8 Ryanard Rd
Wallingford, PA 19086-7143
Phone (484) 483-8411
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PC00932 | PA | MD | Professional Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534723200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534723200000",
"number": "1760962674",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8 RYANARD RD",
"city": "WALLINGFORD",
"state": "PA",
"postal_code": "190867143",
"telephone_number": "484-483-8411"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5060 STATE RD FL 2",
"city": "DREXEL HILL",
"state": "PA",
"postal_code": "190264609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "INZERILLO",
"first_name": "MARY LOUISE",
"middle_name": "ALEXIA",
"credential": "LPC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-20",
"last_updated": "2018-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "101YP2500X",
"taxonomy_group": "",
"desc": "Counselor, Professional",
"state": "PA",
"license": "PC00932",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Drexel Hill, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.