Individual
MRS. CARISSA ANN COSTELLO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMHC
Contact information
Practice address
100 CARMAN AVE, EAST MEADOW, NY 11554-1160
(516) 572-3953
Mailing address
100 CARMAN AVE, EAST MEADOW, NY 11554-1160
(516) 572-3953
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
005335-1
NY
Other
Enumeration date
03/19/2013
Last updated
05/08/2013
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