Provider Demographics
NPI:1982226130
Name:CIULLA, KATELYN ANNE (LMHC)
Entity type:Individual
Prefix:
First Name:KATELYN
Middle Name:ANNE
Last Name:CIULLA
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:KATELYN
Other - Middle Name:ANNE
Other - Last Name:FOWLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:41 SUNFLOWER DR
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-1027
Mailing Address - Country:US
Mailing Address - Phone:516-699-2920
Mailing Address - Fax:
Practice Address - Street 1:41 SUNFLOWER DR
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-1027
Practice Address - Country:US
Practice Address - Phone:516-699-2920
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-05-11
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY102427-01101YM0800X
NY011328101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health