Provider Demographics
NPI:1467840496
Name:GOLDBERG-WEXLER, MELISSA LEIGH (LMSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEIGH
Last Name:GOLDBERG-WEXLER
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2635 NOSTRAND AVE
Mailing Address - Street 2:APARTMENT 6E
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-4615
Mailing Address - Country:US
Mailing Address - Phone:516-318-4986
Mailing Address - Fax:
Practice Address - Street 1:2635 NOSTRAND AVE
Practice Address - Street 2:APARTMENT 6E
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-4615
Practice Address - Country:US
Practice Address - Phone:516-318-4986
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY085801104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker