Provider Demographics
NPI:1093162984
Name:KWIATKOWSKI, MELISSA (LMHC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:KWIATKOWSKI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2044 E 13TH ST APT 6H
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-3358
Mailing Address - Country:US
Mailing Address - Phone:347-276-5345
Mailing Address - Fax:
Practice Address - Street 1:2044 E 13TH ST APT 6H
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-3358
Practice Address - Country:US
Practice Address - Phone:347-276-5345
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2024-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007190101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health