Provider Demographics
NPI:1386517167
Name:SICKLES AVENDANO, MELINA DORIANNE (LSW MSW)
Entity type:Individual
Prefix:
First Name:MELINA
Middle Name:DORIANNE
Last Name:SICKLES AVENDANO
Suffix:
Gender:F
Credentials:LSW MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MILL CREEK CT
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08721-1332
Mailing Address - Country:US
Mailing Address - Phone:732-679-4500
Mailing Address - Fax:
Practice Address - Street 1:22 MILL CREEK CT
Practice Address - Street 2:
Practice Address - City:BAYVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08721-1332
Practice Address - Country:US
Practice Address - Phone:732-679-4500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-26
Last Update Date:2025-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL07324500104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker