Provider Demographics
NPI:1669904041
Name:KNUTS, MELANIE MCGRATH (LCSW)
Entity type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:MCGRATH
Last Name:KNUTS
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:750 COLUMBUS AVE
Mailing Address - Street 2:PHR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10025
Mailing Address - Country:US
Mailing Address - Phone:917-754-1228
Mailing Address - Fax:
Practice Address - Street 1:750 COLUMBUS AVE
Practice Address - Street 2:APT. PHR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10025-6464
Practice Address - Country:US
Practice Address - Phone:917-754-5179
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-04-03
Last Update Date:2017-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR-030354-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker