Individual provider Active NPI

Melissa Ann Selph, MHC

  • Mental Health Counselor
  • Middle Village, NY
National Provider Identifier
1821638081
Registry record updated Mar 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
011906 Issued in NY
Practice address
6317 Metropolitan Ave # B
Middle Village, NY 11379-1634
Phone
(718) 781-6171
NPI assigned
Jan 15, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 011906 NY Primary

Addresses

Primary practice location

6317 Metropolitan Ave # B
Middle Village, NY 11379-1634

Mailing address

6712 70TH Ave FL 1
Glendale, NY 11385-6632
Phone (718) 781-6171

Electronic endpoints 1

TypeEndpointUseAffiliation
Other URL mselphgrowthandtransitions@gmail.com Health Information Exchange (HIE)

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
I20251027002762 NY Practitioner - Mental Health Counselor 3779888391 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2019
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

204 Beach 102ND St
Apt 3
Rockaway Park, NY 11694-2835

204 Beach 102ND St Apt
Suite 3
Rockaway Park, NY 11694-2875

27 Randolph Rd
Howell, NJ 07731-8611

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
011906NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Supportive Care Psychology of Ny PC CurrentSince Oct 1, 2025 Accepting new patients

Locations

27 Randolph Rd
Howell, NJ 07731
Phone (972) 677-7951

7810 164th St
Fresh Meadows, NY 11366
Phone (718) 429-2200

170 Lake St
Liberty, NY 12754
Phone (845) 292-4200

330 Chestnut St
Oneonta, NY 13820
Phone (607) 432-8500

39 Wallace St
Scotia, NY 12302
Phone (518) 346-6458

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1579046400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1742947200000",
    "number": "1821638081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6712 70TH AVE FL 1",
            "city": "GLENDALE",
            "state": "NY",
            "postal_code": "113856632",
            "telephone_number": "718-781-6171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6317 METROPOLITAN AVE # B",
            "city": "MIDDLE VILLAGE",
            "state": "NY",
            "postal_code": "113791634",
            "telephone_number": "718-781-6171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SELPH",
        "first_name": "MELISSA",
        "middle_name": "ANN",
        "credential": "MHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-15",
        "last_updated": "2025-03-26",
        "certification_date": "2025-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "011906",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "mselphgrowthandtransitions@gmail.com",
            "affiliation": "N",
            "endpointDescription": "professional",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "contentOtherDescription": "none",
            "address_1": "6317B Metropolitan Ave",
            "city": "Middle Village",
            "state": "NY",
            "country_code": "US",
            "postal_code": "113791606",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Middle Village, NY

Sources for this page

Verify at the official NPI Registry.