Provider Demographics
NPI:1770600447
Name:PAIGE, MELISSA ELLEN (MSW)
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ELLEN
Last Name:PAIGE
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 EAST 35TH STREET
Mailing Address - Street 2:APT 4L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016
Mailing Address - Country:US
Mailing Address - Phone:917-742-1003
Mailing Address - Fax:646-486-2057
Practice Address - Street 1:148 WEST 24TH STREET
Practice Address - Street 2:SUITE 4A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011
Practice Address - Country:US
Practice Address - Phone:917-742-1003
Practice Address - Fax:646-486-2057
Is Sole Proprietor?:No
Enumeration Date:2007-03-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR03518211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical