Individual
MS. MELISSA SUE GONZALEZ-VAZQUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MSW,CASAC
Contact information
Practice address
113 GLEN COVE AVE, GLEN COVE, NY 11542-3438
(516) 676-2388
(516) 759-5259
Mailing address
1025 MERILLON AVE, WESTBURY, NY 11590-5519
(516) 676-2388
(516) 759-5259
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
21412
NY
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
05/16/2007
Last updated
04/06/2011
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