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General NPI Number Information
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NPI Number | 1780403360
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Entity Type | Individual
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Provider Name | MELISSA SAMANTHA BURT-MILLER LMSW
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Gender | Female
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Dates
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Enumeration Date | 10/09/2024
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Last Update Date | 10/09/2024
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Provider Practice Location Address
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Address Line | 2211 CHURCH AVE
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City | BROOKLYN
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State | NY
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Zip | 11226-3278
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Country | US
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Telephone | 718-643-5300
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Fax |
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Provider Business Mailing Address
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Address Line | 4457 HILL AVE
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City | BRONX
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State | NY
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Zip | 10466-1135
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Country | US
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Telephone | 914-314-7996
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 124941-01
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License Number State | NY
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