Provider Demographics
NPI:1447767082
Name:CHAPPEL, MELODY ROSE (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MELODY
Middle Name:ROSE
Last Name:CHAPPEL
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 1:24 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:MA
Mailing Address - Zip Code:01757-3256
Mailing Address - Country:US
Mailing Address - Phone:617-335-5782
Mailing Address - Fax:
Practice Address - Street 1:705 MOUNT AUBURN ST
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:MA
Practice Address - Zip Code:02472-1508
Practice Address - Country:US
Practice Address - Phone:888-766-9818
Practice Address - Fax:617-972-9424
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-04
Last Update Date:2018-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA114392104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker