Provider Demographics
NPI:1174110639
Name:DOSSANTOS, MELISSA MICHELE (LCSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MICHELE
Last Name:DOSSANTOS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 COUNTY BLDG
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:NY
Mailing Address - Zip Code:12413
Mailing Address - Country:US
Mailing Address - Phone:518-622-9163
Mailing Address - Fax:
Practice Address - Street 1:905 COUNTY BLDG
Practice Address - Street 2:
Practice Address - City:CAIRO
Practice Address - State:NY
Practice Address - Zip Code:12413
Practice Address - Country:US
Practice Address - Phone:518-622-9163
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-12-30
Last Update Date:2024-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY097605104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker