Organization Active NPI

Dr. Melita Psychological Services, PLLC

  • Adolescent and Children Mental Health Clinic/Center
  • New York, NY
National Provider Identifier
1205443066
Registry record updated Sep 25, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adolescent and Children Mental Health Clinic/CenterTaxonomy code 261QM0855X
Legal business name
DR. MELITA PSYCHOLOGICAL SERVICES, PLLC
Practice address
515 Madison Ave FL 21
New York, NY 10022-5433
Phone
(917) 336-1673
NPI assigned
Sep 25, 2020
Last updated
Sep 25, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 25, 2020

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

Authorized official

Name
Dr. Melita Thais Psychological, L,PSYCH PHD
Title
Clinical Psychologist
Phone
(803) 467-9628

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adolescent and Children Mental Health Clinic/Center 261QM0855X Primary

Addresses

Primary practice location

515 Madison Ave FL 21
New York, NY 10022-5433

Mailing address

555 Madison Ave FL 5
New York, NY 10022-3410
Phone (917) 336-1673

National Provider Directory

National Provider Directory

Locations

555 Madison Ave
Fl 5
New York, NY 10022

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1600992000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1600992000000",
    "number": "1205443066",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "555 MADISON AVE FL 5",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100223410",
            "telephone_number": "917-336-1673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "515 MADISON AVE FL 21",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100225433",
            "telephone_number": "917-336-1673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. MELITA PSYCHOLOGICAL SERVICES, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-09-25",
        "last_updated": "2020-09-25",
        "certification_date": "2020-09-25",
        "status": "A",
        "authorized_official_last_name": "PSYCHOLOGICAL",
        "authorized_official_first_name": "MELITA",
        "authorized_official_middle_name": "THAIS",
        "authorized_official_title_or_position": "CLINICAL PSYCHOLOGIST",
        "authorized_official_telephone_number": "803-467-9628",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "L,PSYCH PHD"
    },
    "taxonomies": [
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2020; 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.