Melissa Anne Favaloro, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

72089270 Issued in NY

Practice address

811 W Jericho Tpke Ste 203E
Smithtown, NY 11787-3220

Phone

(631) 375-9308

NPI assigned

Jul 15, 2013

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1373846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1780025130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "301 KENSINGTON CT",
            "city": "COPIAGUE",
            "state": "NY",
            "postal_code": "117264524",
            "telephone_number": "631-375-9308"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 W JERICHO TPKE STE 203E",
            "city": "SMITHTOWN",
            "state": "NY",
            "postal_code": "117873220",
            "telephone_number": "631-375-9308"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FAVALORO",
        "first_name": "MELISSA",
        "middle_name": "ANNE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-07-15",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "72089270",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawn Marie Farina, OTR L
• Sarah Rose Farnworth
• David Farr, M.D.
• Kathleen Ann Farrell
• Michael Fastenberg, M.D.
• Louis Solon Fede Jr., LPN
• Matthew Joseph Fee, CRNA
• Kristin Elaine Feiss
• Sheila Bialek Felberbaum, LCSW
• Taylor Feldman

• Clinical Social Worker in Smithtown, NY
• Providers in Smithtown, NY by specialty
• Clinical Social Worker in New York

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