Provider Demographics
NPI:1356689590
Name:MELLY CAREY, ELYNOR (LMFT)
Entity Type:Individual
Prefix:
First Name:ELYNOR
Middle Name:
Last Name:MELLY CAREY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:ELYNOR
Other - Middle Name:A
Other - Last Name:MELLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMFT
Mailing Address - Street 1:149 CAROLINE RD
Mailing Address - Street 2:
Mailing Address - City:BOZRAH
Mailing Address - State:CT
Mailing Address - Zip Code:06334-1409
Mailing Address - Country:US
Mailing Address - Phone:860-949-2601
Mailing Address - Fax:
Practice Address - Street 1:5 TOWN ST
Practice Address - Street 2:
Practice Address - City:NORWICH
Practice Address - State:CT
Practice Address - Zip Code:06360-2305
Practice Address - Country:US
Practice Address - Phone:860-949-2601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-23
Last Update Date:2013-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT001143106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist