Provider Demographics
NPI:1235537010
Name:MILLIAN KATZ, MELISSA D (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:D
Last Name:MILLIAN KATZ
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:DAWN
Other - Last Name:MILLIAN KATZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LCSW
Mailing Address - Street 1:40 W MAIN ST STE 205
Mailing Address - Street 2:
Mailing Address - City:MOUNT KISCO
Mailing Address - State:NY
Mailing Address - Zip Code:10549-1919
Mailing Address - Country:US
Mailing Address - Phone:914-584-1480
Mailing Address - Fax:
Practice Address - Street 1:40 W MAIN ST STE 205
Practice Address - Street 2:
Practice Address - City:MOUNT KISCO
Practice Address - State:NY
Practice Address - Zip Code:10549-1919
Practice Address - Country:US
Practice Address - Phone:914-584-1480
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087980-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical