Provider Demographics
NPI:1376345116
Name:TORTOLEDO, MELISSA (LPMFT- P110688)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:TORTOLEDO
Suffix:
Gender:F
Credentials:LPMFT- P110688
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 FRONT ST # 2
Mailing Address - Street 2:
Mailing Address - City:MAHOPAC
Mailing Address - State:NY
Mailing Address - Zip Code:10541-2319
Mailing Address - Country:US
Mailing Address - Phone:917-757-9198
Mailing Address - Fax:
Practice Address - Street 1:1940 COMMERCE ST STE 309
Practice Address - Street 2:
Practice Address - City:YORKTOWN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:10598-4449
Practice Address - Country:US
Practice Address - Phone:844-468-5391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-25
Last Update Date:2025-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP110688106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist