Healthcare Provider Details

I. General information

NPI: 1982186920
Provider Name (Legal Business Name): MELENA SADDLER NCC, LMHC, BC-TMH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2018
Last Update Date: 09/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2755 YATES AVE
BRONX NY
10469-5330
US

IV. Provider business mailing address

2755 YATES AVE
BRONX NY
10469-5330
US

V. Phone/Fax

Practice location:
  • Phone: 347-225-1617
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number008158
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: