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General NPI Number Information
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NPI Number | 1639749153
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Entity Type | Organization
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Legal Business Name | MELLA CLANCY-SCHIFILLITI LCSW PC
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Dates
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Enumeration Date | 06/28/2021
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Last Update Date | 06/28/2021
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Provider Practice Location Address
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Address Line | 6800 JERICHO TPKE STE 120W
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City | SYOSSET
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State | NY
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Zip | 11791-4445
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Country | US
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Telephone | 917-940-9980
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Fax |
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Provider Business Mailing Address
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Address Line | 4230 DOUGLASTON PKWY APT 3H
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City | DOUGLASTON
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State | NY
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Zip | 11363-1511
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | LCSW
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Name | MELLA CLANCY-SCHIFILLITI
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Credential |
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Telephone | 917-940-9980
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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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