Provider Demographics
NPI:1467840496
Name:GOLDBERG-WEXLER, MELISSA LEIGH (LCSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:LEIGH
Last Name:GOLDBERG-WEXLER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 HEALY AVE # 2
Mailing Address - Street 2:
Mailing Address - City:FAR ROCKAWAY
Mailing Address - State:NY
Mailing Address - Zip Code:11691-1769
Mailing Address - Country:US
Mailing Address - Phone:516-318-4986
Mailing Address - Fax:
Practice Address - Street 1:123 MAPLE AVE STE 200
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2240
Practice Address - Country:US
Practice Address - Phone:516-308-2558
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-29
Last Update Date:2024-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY091886-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical