Provider Demographics
NPI:1306503008
Name:MILINAZZO, NIELLE DELAYAH (LMHC, ATR)
Entity type:Individual
Prefix:MRS
First Name:NIELLE
Middle Name:DELAYAH
Last Name:MILINAZZO
Suffix:
Gender:F
Credentials:LMHC, ATR
Other - Prefix:MS
Other - First Name:NIELLE
Other - Middle Name:DELAYAH
Other - Last Name:ALFRED
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC, ATR
Mailing Address - Street 1:800 LEXINGTON ST # 1064
Mailing Address - Street 2:
Mailing Address - City:WALTHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02452-4848
Mailing Address - Country:US
Mailing Address - Phone:617-918-7245
Mailing Address - Fax:
Practice Address - Street 1:738 MAIN STREET
Practice Address - Street 2:SUITE 124
Practice Address - City:WALTHAM
Practice Address - State:MA
Practice Address - Zip Code:02451
Practice Address - Country:US
Practice Address - Phone:617-918-7245
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-17
Last Update Date:2023-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA12718-MH-CC101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health