Provider Demographics
NPI:1427195015
Name:DENSMORE, MELANIE CHRISTINE (LICSW)
Entity Type:Individual
Prefix:
First Name:MELANIE
Middle Name:CHRISTINE
Last Name:DENSMORE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:363 COURT ST SUITE 1
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02360
Mailing Address - Country:US
Mailing Address - Phone:508-746-8004
Mailing Address - Fax:508-746-8099
Practice Address - Street 1:363 COURT ST SUITE 1
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360
Practice Address - Country:US
Practice Address - Phone:508-746-8004
Practice Address - Fax:508-746-8099
Is Sole Proprietor?:No
Enumeration Date:2007-01-31
Last Update Date:2015-11-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1137651041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical