Provider Demographics
NPI:1265688436
Name:MORGAN, MELISSA (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MORGAN
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 1:2215 43RD AVE
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:LONG ISLAND CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11101-5018
Mailing Address - Country:US
Mailing Address - Phone:718-389-5100
Mailing Address - Fax:718-752-4809
Practice Address - Street 1:421 27TH AVE
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:NY
Practice Address - Zip Code:11102-4175
Practice Address - Country:US
Practice Address - Phone:718-956-1305
Practice Address - Fax:718-956-4573
Is Sole Proprietor?:No
Enumeration Date:2008-08-07
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY079606-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker