Provider Demographics
NPI:1386359347
Name:TALLY, MELISSA MARGARET (MSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARGARET
Last Name:TALLY
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:196 FRIENDS RD
Mailing Address - Street 2:
Mailing Address - City:YORKTOWN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:10598-4302
Mailing Address - Country:US
Mailing Address - Phone:914-652-8260
Mailing Address - Fax:
Practice Address - Street 1:20 CHURCH ST STE 2
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10601-1926
Practice Address - Country:US
Practice Address - Phone:914-683-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker