Provider Demographics
NPI:1942757836
Name:SANTANA, MELISSA
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:SANTANA
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:BUSHWICK CHILD AND FAMILY MENTAL HEALTH CENTER
Mailing Address - Street 2:102 PILLING STREET
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-2772
Mailing Address - Country:US
Mailing Address - Phone:718-602-1000
Mailing Address - Fax:
Practice Address - Street 1:BUSHWICK CHILD AND FAMILY MENTAL HEALTH CENTER
Practice Address - Street 2:102 PILLING STREET
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207
Practice Address - Country:US
Practice Address - Phone:718-602-1000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health