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General NPI Number Information
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NPI Number | 1528709045
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Entity Type | Organization
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Legal Business Name | M BACKUS LCSW INC.
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 928 IRIS DR
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City | DELRAY BEACH
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State | FL
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Zip | 33483-4811
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Country | US
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Telephone | 917-275-7429
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Fax |
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Provider Business Mailing Address
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Address Line | 235 E 95TH ST
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City | NEW YORK
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State | NY
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Zip | 10128-4012
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Country | US
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Telephone | 347-499-2477
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | MELISSA BACKUS
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Credential | LCSW
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Telephone | 917-275-7429
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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