Provider Demographics
NPI:1740725688
Name:MORNE, ANTHEA MELANIE (RN, LMHC, PHD, CASAC)
Entity type:Individual
Prefix:MS
First Name:ANTHEA
Middle Name:MELANIE
Last Name:MORNE
Suffix:
Gender:F
Credentials:RN, LMHC, PHD, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:369 GRAND ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-3613
Mailing Address - Country:US
Mailing Address - Phone:845-569-1302
Mailing Address - Fax:845-565-4387
Practice Address - Street 1:369 GRAND ST
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-3613
Practice Address - Country:US
Practice Address - Phone:845-569-1302
Practice Address - Fax:845-565-4387
Is Sole Proprietor?:Yes
Enumeration Date:2017-01-02
Last Update Date:2017-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY179956-1101Y00000X
NY12427101YA0400X
VIPH.D CERTIFICATE103TA0700X
NY000668-1103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging