Provider Demographics
NPI:1316298821
Name:MYERS, MELINDA Y (LMHC)
Entity type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:Y
Last Name:MYERS
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MRS
Other - First Name:MELINDA
Other - Middle Name:Y
Other - Last Name:MYERS-KELLEGHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 219
Mailing Address - Street 2:
Mailing Address - City:WYNANTSKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12198-0219
Mailing Address - Country:US
Mailing Address - Phone:518-283-6500
Mailing Address - Fax:518-283-7156
Practice Address - Street 1:614 COOPER HILL RD
Practice Address - Street 2:
Practice Address - City:WYNANTSKILL
Practice Address - State:NY
Practice Address - Zip Code:12198-2906
Practice Address - Country:US
Practice Address - Phone:518-283-6500
Practice Address - Fax:518-283-7156
Is Sole Proprietor?:No
Enumeration Date:2012-09-24
Last Update Date:2023-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP96926101YM0800X
NY008251101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY008251-1OtherLICENSED MENTAL HEALTH COUNSELOR