Provider Demographics
NPI:1831860832
Name:MELSON, AMY ELIZABETH (LMSW)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:ELIZABETH
Last Name:MELSON
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 1:7881 COUNTY HIGHWAY 14
Mailing Address - Street 2:
Mailing Address - City:DELHI
Mailing Address - State:NY
Mailing Address - Zip Code:13753-8739
Mailing Address - Country:US
Mailing Address - Phone:917-670-7102
Mailing Address - Fax:
Practice Address - Street 1:56 SHEPARD ST
Practice Address - Street 2:
Practice Address - City:WALTON
Practice Address - State:NY
Practice Address - Zip Code:13856-1109
Practice Address - Country:US
Practice Address - Phone:607-832-5889
Practice Address - Fax:607-832-6082
Is Sole Proprietor?:No
Enumeration Date:2021-09-21
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1021351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical