Provider Demographics
NPI:1467652487
Name:PISTILLI, MELANIE CARLA (MED/CADC)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:CARLA
Last Name:PISTILLI
Suffix:
Gender:F
Credentials:MED/CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2501 EBRIGHT RD
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19810-1125
Mailing Address - Country:US
Mailing Address - Phone:302-477-3960
Mailing Address - Fax:302-477-3963
Practice Address - Street 1:2501 EBRIGHT ROAD
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19810-1198
Practice Address - Country:US
Practice Address - Phone:302-477-3960
Practice Address - Fax:302-477-3963
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2011-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DE635101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)