Provider Demographics
NPI:1700084274
Name:ARKER, MELISSA SAVAGE (MSED)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:SAVAGE
Last Name:ARKER
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 E 65TH ST
Mailing Address - Street 2:APT 14G
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6616
Mailing Address - Country:US
Mailing Address - Phone:917-509-5861
Mailing Address - Fax:
Practice Address - Street 1:250 E 65TH ST
Practice Address - Street 2:APT 14G
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-6616
Practice Address - Country:US
Practice Address - Phone:917-509-5861
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-06
Last Update Date:2012-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
174400000X
NY002323-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No174400000XOther Service ProvidersSpecialist