Provider Demographics
NPI:1841920964
Name:STAATS, MELISSA (LMSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:STAATS
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 1:1 BIRCH LN
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-4202
Mailing Address - Country:US
Mailing Address - Phone:914-610-0602
Mailing Address - Fax:
Practice Address - Street 1:175 GREEN STREET
Practice Address - Street 2:ALBANY COUNTY DEPARTMENT OF MENTAL HEALTH
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12202
Practice Address - Country:US
Practice Address - Phone:518-447-5916
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-13
Last Update Date:2022-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0556771041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical