Healthcare Provider Details

I. General information

NPI: 1598053852
Provider Name (Legal Business Name): MELISSA SPINELLI MOSER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/20/2011
Last Update Date: 09/30/2026
Certification Date: 09/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

70 KUKUK LN
KINGSTON NY
12401-6943
US

IV. Provider business mailing address

6 WILLOW CT
ULSTER PARK NY
12487-5361
US

V. Phone/Fax

Practice location:
  • Phone: 845-336-2616
  • Fax:
Mailing address:
  • Phone: 845-658-7885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101823-01
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: