Active NPI
K. Melissa Waterman, LCSW-R
- Clinical Social Worker
- New Paltz, NY
National Provider Identifier
1104842715
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R056648-1
- Practice address
- 136 N Chestnut St Apt 9C
New Paltz, NY 12561-1021 - Phone
- (845) 464-8910
- NPI assigned
- Jul 15, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R056648-1 | NY | Primary |
Addresses
Primary practice location
136 N Chestnut St Apt 9C
New Paltz, NY 12561-1021
Mailing address
136 N Chestnut St Apt 9C
New Paltz, NY 12561-1021
Phone (845) 464-8910
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| R056648-1 | NY | MD | Clinical Social Worker |
| 056648 | NY | MD | Oral and Maxillofacial Surgery (Dentist) |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152921600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1769990400000",
"number": "1104842715",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "136 N CHESTNUT ST APT 9C",
"city": "NEW PALTZ",
"state": "NY",
"postal_code": "125611021",
"telephone_number": "845-464-8910"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 N CHESTNUT ST APT 9C",
"city": "NEW PALTZ",
"state": "NY",
"postal_code": "125611021",
"telephone_number": "845-464-8910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WATERMAN",
"first_name": "K. MELISSA",
"credential": "LCSW-R",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-07-15",
"last_updated": "2026-02-02",
"certification_date": "2026-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R056648-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in New Paltz, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.