Mortellaro, David L

Mortellaro, David L is an individual health care provider with primary practice located at 4656 Brambleton Ave , Roanoke VA 24018-3437. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Mental Health, Behavioral Health & Social Service Providers / Marriage & Family Therapist. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Mortellaro, David L can be contacted via phone (540) 772-8043.

Contact Information

Primary practice address
4656 Brambleton Ave Roanoke VA 24018-3437
Phone: (540) 772-8043
Fax: (540) 772-8242
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X 0701001496 Virginia
Behavioral Health & Social Service Providers / Marriage & Family Therapist 106H00000X 0717000603 Virginia

Profile Details

NPI number 1851375836
LBN Legal business name Mortellaro, David L
Credentials LPC, LMFT
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 2nd, 2005
Last updated Oct 2nd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1851375836 NPPES
Virginia Other 005400431 VIRGINIA PREMIER (HMO)
Virginia MEDICAID 005400431 VIRGINIA PREMIER (HMO)
Virginia Other 297608000 VIRGINIA PREMIER (HMO)
Virginia Other 087620 VIRGINIA PREMIER (HMO)
Virginia Other JOHN DEERE VIRGINIA PREMIER (HMO)
Virginia Other 018061 VIRGINIA PREMIER (HMO)
Virginia Other 132303 VIRGINIA PREMIER (HMO)
Virginia Other 349980 VIRGINIA PREMIER (HMO)
Virginia Other 285978 VIRGINIA PREMIER (HMO)
Virginia Other 5675123 VIRGINIA PREMIER (HMO)
Virginia Other 69554 VIRGINIA PREMIER (HMO)

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