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General NPI Number Information
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NPI Number | 1902758014
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Entity Type | Individual
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Provider Name | GREGORY L MELLON M.S.ED , LMHC
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Gender | Male
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Dates
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Enumeration Date | 02/11/2026
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Last Update Date | 02/11/2026
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Provider Practice Location Address
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Address Line | 738 CROWN ST
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City | BROOKLYN
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State | NY
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Zip | 11213-5423
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Country | US
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Telephone | 718-363-0100
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Fax |
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Provider Business Mailing Address
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Address Line | 750 LEFFERTS AVE APT B2
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City | BROOKLYN
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State | NY
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Zip | 11203-1220
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Country | US
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Telephone | 718-635-0211
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | P140372
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License Number State | NY
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