| Raphael Revella Licensed Clinical Social Work Pllc | |
|
432 4th Ave Apt 9 Troy NY 12182-3034 | |
| (518) 630-8351 | |
| Not Available |
| Full Name | Raphael Revella Licensed Clinical Social Work Pllc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 432 4th Ave Apt 9, Troy, New York |
| Authorized Official Name and Position | Raphael Angela Revella (OWNER/MANAGER) |
| Authorized Official Contact | 5186308351 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Raphael Revella Licensed Clinical Social Work Pllc 432 4th Ave Apt 9 Troy NY 12182-3034 Ph: (518) 630-8351 | Raphael Revella Licensed Clinical Social Work Pllc 432 4th Ave Apt 9 Troy NY 12182-3034 Ph: (518) 630-8351 |
| NPI Number | 1245033158 |
|---|---|
| Provider Enumeration Date | 03/28/2025 |
| Last Update Date | 03/28/2025 |
| Certification Date | 03/28/2025 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245033158 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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