Individual provider Active NPI

Melissa Dougherty, LCSW

  • Clinical Social Worker
  • Taghkanic, NY
National Provider Identifier
1790446755
Registry record updated Nov 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
114652-01 Issued in NY
Practice address
87 Craryville Rd
Taghkanic, NY 12521-5556
Phone
(650) 906-1410
NPI assigned
Jan 3, 2022
Last updated
Nov 21, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 21, 2025

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 114652-01 NY Primary

Addresses

Primary practice location

87 Craryville Rd
Taghkanic, NY 12521-5556

Mailing address

10 Montague Ter
Brooklyn, NY 11201-4117

Other identifiers 1

IdentifierTypeStateIssuer
101420-01OtherNYSTATE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251203001132 NY Practitioner - Clinical Social Worker 1355834805 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Institute for Family HealthGroup PAC ID 9234048588, 188 clinicians

Practice addresses (Care Compare)

1 Family Practice Dr
Kingston, NY 12401-6449
Phone (845) 338-6400

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
114652-01NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
The Institute for Family Health Clinical Current Accepting new patients
The Institute for Family Health Clinical CurrentSince Oct 30, 2025 Accepting new patients
The Institute for Family Health Clinical CurrentSince Oct 30, 2025 Accepting new patients

Locations

1 Family Practice Dr
Kingston, NY 12401
Phone (845) 338-2562

140 Pine St
Kingston, NY 12401
Phone (844) 434-2778

16 E 16th St
New York, NY 10003
Phone (212) 633-0800

1824 Madison Ave
New York, NY 10035
Phone (212) 423-4200

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1641168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1763683200000",
    "number": "1790446755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 MONTAGUE TER",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112014117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "87 CRARYVILLE RD",
            "city": "TAGHKANIC",
            "state": "NY",
            "postal_code": "125215556",
            "telephone_number": "650-906-1410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DOUGHERTY",
        "first_name": "MELISSA",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-03",
        "last_updated": "2025-11-21",
        "certification_date": "2025-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "114652-01",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE",
            "identifier": "101420-01",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Sources for this page

Verify at the official NPI Registry.