Healthcare Provider Details

I. General information

NPI: 1427765965
Provider Name (Legal Business Name): MELINDA PUTRELO LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/03/2022
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1169 PITTSFORD VICTOR RD STE 200
PITTSFORD NY
14534-3814
US

IV. Provider business mailing address

435 OXFORD ST APT 2
ROCHESTER NY
14607-3235
US

V. Phone/Fax

Practice location:
  • Phone: 585-895-6191
  • Fax: 585-895-2770
Mailing address:
  • Phone: 315-525-4880
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: