Provider Demographics
NPI:1326618257
Name:HOSKINS, MELISSA JANE (LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:JANE
Last Name:HOSKINS
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 1:69 POND RD
Mailing Address - Street 2:
Mailing Address - City:LEWISTON
Mailing Address - State:ME
Mailing Address - Zip Code:04240-1608
Mailing Address - Country:US
Mailing Address - Phone:207-784-2703
Mailing Address - Fax:
Practice Address - Street 1:256 BARTLETT ST
Practice Address - Street 2:
Practice Address - City:LEWISTON
Practice Address - State:ME
Practice Address - Zip Code:04240-6501
Practice Address - Country:US
Practice Address - Phone:207-784-2703
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-07-01
Last Update Date:2021-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MELC151441041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME7978269OtherDRIVERS LICENSE