Provider Demographics
NPI:1659265205
Name:DE OSAMBELA, MELINA (LMSW)
Entity type:Individual
Prefix:
First Name:MELINA
Middle Name:
Last Name:DE OSAMBELA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 OAK RIDGE GATE
Mailing Address - Street 2:
Mailing Address - City:DANBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06810-5030
Mailing Address - Country:US
Mailing Address - Phone:203-822-0535
Mailing Address - Fax:
Practice Address - Street 1:25 OAK RIDGE GATE
Practice Address - Street 2:
Practice Address - City:DANBURY
Practice Address - State:CT
Practice Address - Zip Code:06810-5030
Practice Address - Country:US
Practice Address - Phone:203-822-0535
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-06
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT112801041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical