Provider Demographics
NPI:1467500629
Name:SCHONFIELD, MELISA RAE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELISA
Middle Name:RAE
Last Name:SCHONFIELD
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 1:1304 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:13601-4500
Mailing Address - Country:US
Mailing Address - Phone:315-771-4013
Mailing Address - Fax:315-788-4108
Practice Address - Street 1:1304 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-4500
Practice Address - Country:US
Practice Address - Phone:315-771-4013
Practice Address - Fax:315-788-4108
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY730699991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical