Provider Demographics
NPI:1598315566
Name:LIPPIELLO, MELISSA FIORE
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:FIORE
Last Name:LIPPIELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:227 READ AVE
Mailing Address - Street 2:
Mailing Address - City:TUCKAHOE
Mailing Address - State:NY
Mailing Address - Zip Code:10707-2319
Mailing Address - Country:US
Mailing Address - Phone:646-345-6757
Mailing Address - Fax:
Practice Address - Street 1:7-11 S BROADWAY STE 317
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-3520
Practice Address - Country:US
Practice Address - Phone:914-948-8004
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-09-12
Last Update Date:2019-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101913-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker