Healthcare Provider Details

I. General information

NPI: 1881352136
Provider Name (Legal Business Name): MELISSA JILL SAKOFSKY KANARA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2021
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 KREAG RD STE 202B5
PITTSFORD NY
14534-3737
US

IV. Provider business mailing address

640 KREAG RD STE 202B5
PITTSFORD NY
14534-3737
US

V. Phone/Fax

Practice location:
  • Phone: 585-210-2279
  • Fax:
Mailing address:
  • Phone: 585-210-2279
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number016332
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10427
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: