Organization
CHANEL V. TAZZA, MENTAL HEALTH COUNSELING, P.C.
Active
Other names
Awaken Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHANEL VIVIANA TAZZA LMHC (MENTAL HEALTH COUNSELOR/OWNER)
(646) 456-0819
Entity
Organization
Contact information
Practice address
63 SCUDDERS LN, GLEN HEAD, NY 11545-1535
(646) 456-0819
Mailing address
63 SCUDDERS LN, GLEN HEAD, NY 11545-1535
(646) 456-0819
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
07679601
—
NY
01
—
1053510354
NPI TYPE I
NY
01
—
1386114692
GROUP PRACTICE NPI
NY
Enumeration date
11/29/2018
Last updated
03/28/2024
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