=====================================================
General NPI Number Information
=====================================================
NPI Number | 1760546394
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MELISSA BETH GINSBERG-ALLETTO LCSW
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 12/20/2006
-----------------------------------------------------
Last Update Date | 03/03/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 395 N SERVICE RD
-----------------------------------------------------
City | MELVILLE
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11747-3139
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 631-844-2409
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1 WOOD LN
-----------------------------------------------------
City | LOCUST VALLEY
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11560-1628
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 516-650-0660
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 1041C0700X
-----------------------------------------------------
Taxonomy Name | Clinical Social Worker
-----------------------------------------------------
License Number | 089884
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 104100000X
-----------------------------------------------------
Taxonomy Name | Social Worker
-----------------------------------------------------
License Number | 049844-1
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------