=====================================================
General NPI Number Information
=====================================================
NPI Number | 1275485005
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | MIND BASE PSYCHOTHERAPY LCSW PLLC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/12/2026
-----------------------------------------------------
Last Update Date | 02/12/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 152 POST AVE STE 8
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10034-2643
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-300-0551
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 2800 PARKVIEW TER APT 5A
-----------------------------------------------------
City | BRONX
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10468-1532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 646-300-0551
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | MELISSA S SALCE
-----------------------------------------------------
Credential | LCSW
-----------------------------------------------------
Telephone | 646-306-2551
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------