Provider Demographics
NPI:1821568056
Name:ROOKMAN, MELISSA KAY (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:KAY
Last Name:ROOKMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:MELISSA
Other - Middle Name:KAY
Other - Last Name:PARKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:39053 CREEK RD
Mailing Address - Street 2:
Mailing Address - City:THERESA
Mailing Address - State:NY
Mailing Address - Zip Code:13691-2051
Mailing Address - Country:US
Mailing Address - Phone:315-572-9378
Mailing Address - Fax:
Practice Address - Street 1:20104 NYS RT 3
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:NY
Practice Address - Zip Code:13601-5560
Practice Address - Country:US
Practice Address - Phone:315-779-7233
Practice Address - Fax:315-779-7109
Is Sole Proprietor?:No
Enumeration Date:2018-11-30
Last Update Date:2020-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0875421041C0700X
NY13437631041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical