Clemens Mccloud, Melinda E
Clemens Mccloud, Melinda E is an individual health care provider with primary practice located at 350 Jericho Tpke Ste 103 , Jericho NY 11753-1317. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Clemens Mccloud, Melinda E can be contacted via phone (631) 245-7505.Contact Information
Primary practice address
350 Jericho Tpke Ste 103
Jericho NY 11753-1317
Phone: (631) 245-7505
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 096870 | New York |
Profile Details
| NPI number | 1720253024 |
|---|---|
| LBN Legal business name | Clemens Mccloud, Melinda E |
| Credentials | Licensed Clinical Social Worker (LCSW) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 28th, 2008 |
| Last updated | Feb 25th, 2024 - about 10 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720253024 | NPPES |
| New York | MEDICAID | 07200073960 |
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