| Doctor Name: | MR. JEFFREY R CODELLA |
| NPI Number: | 1003866021 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.S.ED., LMHC |
| License Number: | 5529 |
| Business Practice Address: | 279 N Main St Fall River, MA - 027202320 |
| Business Phone Number: | 5086790033 |
| Business Fax Number: | |
| Mailing Address: | 279 N Main St, FALL RIVER |
| State: | MA |
| Postal Code: | 027202320 |
| Phone Number: | 5086790033 |
| Fax Number: | |
| NPI Enumeration Date: | 05/11/2006 |
| NPI Last Update Date: | 05/11/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | 5529 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |