Provider Demographics
NPI:1750786364
Name:BECKLES- CANTON, SANAYI MELYSSA (LMSW)
Entity type:Individual
Prefix:
First Name:SANAYI
Middle Name:MELYSSA
Last Name:BECKLES- CANTON
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7000 AUSTIN ST STE 200
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375-4739
Mailing Address - Country:US
Mailing Address - Phone:212-470-5852
Mailing Address - Fax:
Practice Address - Street 1:620 LENOX AVE APT 11E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10037-1206
Practice Address - Country:US
Practice Address - Phone:212-470-5852
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-24
Last Update Date:2014-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091954104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker