Provider Demographics
NPI:1063037455
Name:CHIPOLLINI, MELISSA (PSYD; LPC)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:
Last Name:CHIPOLLINI
Suffix:
Gender:F
Credentials:PSYD; LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 43
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10159-0043
Mailing Address - Country:US
Mailing Address - Phone:484-442-0521
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 43
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10159-0043
Practice Address - Country:US
Practice Address - Phone:484-442-0521
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-11
Last Update Date:2024-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00946100101YP2500X
PAPC012206101YP2500X
NY026526103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional