Provider Demographics
NPI:1952052342
Name:MAKAK, MELISSA (LMHC)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:MAKAK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MR
Other - First Name:MATTHEW
Other - Middle Name:
Other - Last Name:MAKAK
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:1559 E 21ST ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-5049
Mailing Address - Country:US
Mailing Address - Phone:646-420-7660
Mailing Address - Fax:
Practice Address - Street 1:55 LEXINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-5585
Practice Address - Country:US
Practice Address - Phone:646-312-4624
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011619101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health