Provider Demographics
NPI:1083506125
Name:MELECH MANN LLC
Entity type:Organization
Organization Name:MELECH MANN LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BUSINESS OWNER AND PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:MELECH
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:MANN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:929-278-0537
Mailing Address - Street 1:1032 BAY 24TH ST
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1802
Mailing Address - Country:US
Mailing Address - Phone:929-278-0537
Mailing Address - Fax:
Practice Address - Street 1:797 BRIGHTON AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2736
Practice Address - Country:US
Practice Address - Phone:929-278-0537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-15
Last Update Date:2025-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty