Active NPI
Melissa Fortunato, LMHC
- Mental Health Counselor
- New York, NY
National Provider Identifier
1831664390
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 010585
- Practice address
- 136 Madison Ave
New York, NY 10016-6711 - Phone
- (516) 476-7686
- NPI assigned
- Oct 10, 2018
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 010585 | NY | Primary |
Addresses
Primary practice location
136 Madison Ave
New York, NY 10016-6711
Mailing address
64 Parkside Dr N
Levittown, NY 11756-1528
Phone (516) 476-7686
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 010585 | NY | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1539129600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1595376000000",
"number": "1831664390",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "64 PARKSIDE DR N",
"city": "LEVITTOWN",
"state": "NY",
"postal_code": "117561528",
"telephone_number": "516-476-7686"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "136 MADISON AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100166711",
"telephone_number": "516-476-7686"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FORTUNATO",
"first_name": "MELISSA",
"credential": "LMHC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-10-10",
"last_updated": "2020-07-22",
"certification_date": "2020-07-22",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "010585",
"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 Jul 22, 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.