Individual provider Active NPI

Melinda Maldonado, LCSW-R, CASAC

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1053178293
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R080753-01 Issued in NY
Practice address
397 Bridge St
Brooklyn, NY 11201-5292
Phone
(631) 532-8353
NPI assigned
Mar 4, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R080753-01 NY Primary

Addresses

Primary practice location

397 Bridge St
Brooklyn, NY 11201-5292

Mailing address

PO Box 40423
Glen Oaks, NY 11004-0423

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
R080753-01NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1709510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1053178293",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 40423",
            "city": "GLEN OAKS",
            "state": "NY",
            "postal_code": "110040423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "397 BRIDGE ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112015292",
            "telephone_number": "631-532-8353"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MALDONADO",
        "first_name": "MELINDA",
        "credential": "LCSW-R, CASAC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-03-04",
        "last_updated": "2024-03-04",
        "certification_date": "2024-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R080753-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.