Healthcare Provider Details

I. General information

NPI: 1740725688
Provider Name (Legal Business Name): ANTHEA MELANIE MORNE RN, LMHC, PHD, CASAC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/02/2017
Last Update Date: 01/02/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

369 GRAND ST
NEWBURGH NY
12550-3613
US

IV. Provider business mailing address

369 GRAND ST
NEWBURGH NY
12550-3613
US

V. Phone/Fax

Practice location:
  • Phone: 845-569-1302
  • Fax: 845-565-4387
Mailing address:
  • Phone: 845-569-1302
  • Fax: 845-565-4387

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number179956-1
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number12427
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TA0700X
TaxonomyAdult Development & Aging Psychologist
License NumberPH.D CERTIFICATE
License Number StateVI
# 4
Primary TaxonomyY
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number000668-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: