Provider Demographics
NPI:1841985496
Name:BADILLO, MELODIE (MSED)
Entity type:Individual
Prefix:
First Name:MELODIE
Middle Name:
Last Name:BADILLO
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 1:6 QUINCY RD
Mailing Address - Street 2:
Mailing Address - City:PUTNAM VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10579-2724
Mailing Address - Country:US
Mailing Address - Phone:914-844-1864
Mailing Address - Fax:
Practice Address - Street 1:545 SAW MILL RIVER RD STE 3A
Practice Address - Street 2:
Practice Address - City:ARDSLEY
Practice Address - State:NY
Practice Address - Zip Code:10502-2159
Practice Address - Country:US
Practice Address - Phone:347-625-5423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-04-10
Last Update Date:2023-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health