Provider Demographics
NPI:1306486063
Name:RHIM, MELINDA ANN (LMSW)
Entity type:Individual
Prefix:
First Name:MELINDA
Middle Name:ANN
Last Name:RHIM
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:ANN
Other - Last Name:MAEDL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:12 HAMMOND PKWY
Mailing Address - Street 2:
Mailing Address - City:MIDDLEPORT
Mailing Address - State:NY
Mailing Address - Zip Code:14105-1103
Mailing Address - Country:US
Mailing Address - Phone:585-739-4287
Mailing Address - Fax:
Practice Address - Street 1:14014 ROUTE 31
Practice Address - Street 2:
Practice Address - City:ALBION
Practice Address - State:NY
Practice Address - Zip Code:14411-9301
Practice Address - Country:US
Practice Address - Phone:585-589-7066
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-10
Last Update Date:2020-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY061590104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker