Provider Demographics
NPI:1447435581
Name:SCELSA, JOSEPH VINCENT (EDD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:VINCENT
Last Name:SCELSA
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:41 CARWALL AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10552-1211
Mailing Address - Country:US
Mailing Address - Phone:914-667-0192
Mailing Address - Fax:914-667-0192
Practice Address - Street 1:1806 HERING AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461-1802
Practice Address - Country:US
Practice Address - Phone:718-931-6935
Practice Address - Fax:347-810-1028
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-08
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000609101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health