Provider Demographics
NPI:1518437136
Name:MELISSA KATE MCINTOSH, INC.
Entity Type:Organization
Organization Name:MELISSA KATE MCINTOSH, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:KATE
Authorized Official - Last Name:MCINTOSH
Authorized Official - Suffix:
Authorized Official - Credentials:LCAT, ATR-BC
Authorized Official - Phone:646-236-3349
Mailing Address - Street 1:167 W. 21ST ST., #3SE
Mailing Address - Street 2:
Mailing Address - City:NY
Mailing Address - State:NY
Mailing Address - Zip Code:10011
Mailing Address - Country:US
Mailing Address - Phone:646-236-3349
Mailing Address - Fax:646-350-1529
Practice Address - Street 1:167 W. 21ST ST., #3SE
Practice Address - Street 2:
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:646-236-3349
Practice Address - Fax:646-350-1529
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-11-26
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty