Provider Demographics
NPI:1457835332
Name:NOVAKOFF, MELISSA BETH (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MELISSA
Middle Name:BETH
Last Name:NOVAKOFF
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 1:285 COMMANDANTS WAY
Mailing Address - Street 2:
Mailing Address - City:CHELSEA
Mailing Address - State:MA
Mailing Address - Zip Code:02150-4057
Mailing Address - Country:US
Mailing Address - Phone:617-241-3871
Mailing Address - Fax:617-241-7452
Practice Address - Street 1:285 COMMANDANTS WAY
Practice Address - Street 2:
Practice Address - City:CHELSEA
Practice Address - State:MA
Practice Address - Zip Code:02150-4057
Practice Address - Country:US
Practice Address - Phone:617-241-3871
Practice Address - Fax:617-241-7452
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1141721041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool