Provider Demographics
NPI:1467234351
Name:MELENDEZ, RICHARD R (LMHC)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:R
Last Name:MELENDEZ
Suffix:
Gender:M
Credentials:LMHC
Other - Prefix:MR
Other - First Name:RICHARD
Other - Middle Name:R
Other - Last Name:MELENDEZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:17 ELWOOD RD
Mailing Address - Street 2:
Mailing Address - City:DELMAR
Mailing Address - State:NY
Mailing Address - Zip Code:12054-2403
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:17 ELWOOD RD
Practice Address - Street 2:
Practice Address - City:DELMAR
Practice Address - State:NY
Practice Address - Zip Code:12054-2403
Practice Address - Country:US
Practice Address - Phone:518-332-9463
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-16
Last Update Date:2023-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY013906101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health