Provider Demographics
NPI:1366736076
Name:VISALLI, ALYSSA (MA, LMHC)
Entity type:Individual
Prefix:MISS
First Name:ALYSSA
Middle Name:
Last Name:VISALLI
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7702 MASSACHUSETTS AVE
Mailing Address - Street 2:
Mailing Address - City:NEW PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34653-3024
Mailing Address - Country:US
Mailing Address - Phone:727-847-0069
Mailing Address - Fax:727-849-3780
Practice Address - Street 1:7702 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:NEW PORT RICHEY
Practice Address - State:FL
Practice Address - Zip Code:34653-3024
Practice Address - Country:US
Practice Address - Phone:727-847-0069
Practice Address - Fax:727-849-3780
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-31
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH 10787101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health