Provider Demographics
NPI:1477662252
Name:BRAMLEY, MELISSA (LCSW-R)
Entity Type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:
Last Name:BRAMLEY
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 MAIN ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:CORTLAND
Mailing Address - State:NY
Mailing Address - Zip Code:13045-6606
Mailing Address - Country:US
Mailing Address - Phone:607-662-0209
Mailing Address - Fax:607-662-0238
Practice Address - Street 1:17 MAIN ST
Practice Address - Street 2:SUITE 202
Practice Address - City:CORTLAND
Practice Address - State:NY
Practice Address - Zip Code:13045-6606
Practice Address - Country:US
Practice Address - Phone:607-662-0209
Practice Address - Fax:607-662-0238
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-29
Last Update Date:2007-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR053483-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical