Provider Demographics
NPI:1689465536
Name:MELISSA FOGEL, LLC
Entity type:Organization
Organization Name:MELISSA FOGEL, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED PSYCHOLOGIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:R
Authorized Official - Last Name:FOGEL
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:941-809-8359
Mailing Address - Street 1:747 NEW JERSEY ST
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33401-6643
Mailing Address - Country:US
Mailing Address - Phone:941-809-8359
Mailing Address - Fax:
Practice Address - Street 1:2161 PALM BEACH LAKES BLVD
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-6607
Practice Address - Country:US
Practice Address - Phone:941-809-8359
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-05-12
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health