Provider Demographics
NPI:1215526942
Name:BENNETT, CARMELA CELESTE (LMHC)
Entity type:Individual
Prefix:DR
First Name:CARMELA
Middle Name:CELESTE
Last Name:BENNETT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 RIVERSIDE DR APT 8I
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-7434
Mailing Address - Country:US
Mailing Address - Phone:484-797-7737
Mailing Address - Fax:
Practice Address - Street 1:790 RIVERSIDE DR APT 8I
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-7434
Practice Address - Country:US
Practice Address - Phone:484-797-7737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-17
Last Update Date:2021-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010831-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health