Provider Demographics
NPI:1053192864
Name:INOA, VELENISS (SA, LCPC, NP, LPC,)
Entity type:Individual
Prefix:
First Name:VELENISS
Middle Name:
Last Name:INOA
Suffix:
Gender:F
Credentials:SA, LCPC, NP, LPC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3044 ALBANY CRES
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10463-5622
Mailing Address - Country:US
Mailing Address - Phone:347-327-8042
Mailing Address - Fax:
Practice Address - Street 1:1160 CROMWELL AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-8707
Practice Address - Country:US
Practice Address - Phone:347-327-8042
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-09
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYSC171400080101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty