Provider Demographics
NPI:1508078965
Name:BLANCHETTE, MELVIN CHARLES (PHD)
Entity Type:Individual
Prefix:DR
First Name:MELVIN
Middle Name:CHARLES
Last Name:BLANCHETTE
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:401 MICHIGAN AVE NE
Mailing Address - Street 2:SUITE 409
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20017-1518
Mailing Address - Country:US
Mailing Address - Phone:202-756-5916
Mailing Address - Fax:202-756-4909
Practice Address - Street 1:401 MICHIGAN AVE NE
Practice Address - Street 2:SUITE 409
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20017-1518
Practice Address - Country:US
Practice Address - Phone:202-756-5916
Practice Address - Fax:202-756-4909
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD01368103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist