Provider Demographics
NPI:1255693214
Name:MAHADY, MELANIE MARIE (MS)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:MARIE
Last Name:MAHADY
Suffix:
Gender:F
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2400 YAMATO RD
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-8403
Mailing Address - Country:US
Mailing Address - Phone:561-241-9014
Mailing Address - Fax:561-994-2263
Practice Address - Street 1:2400 YAMATO RD
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-8403
Practice Address - Country:US
Practice Address - Phone:561-241-9014
Practice Address - Fax:561-994-2263
Is Sole Proprietor?:No
Enumeration Date:2012-06-14
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH11800101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health