Provider Demographics
NPI:1508126830
Name:MELENDEZ, MELISSA IVETTE (MSW, LCSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:IVETTE
Last Name:MELENDEZ
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11 WEBB ST
Mailing Address - Street 2:
Mailing Address - City:METHUEN
Mailing Address - State:MA
Mailing Address - Zip Code:01844-2961
Mailing Address - Country:US
Mailing Address - Phone:978-387-3392
Mailing Address - Fax:
Practice Address - Street 1:93 EUCLID AVE
Practice Address - Street 2:
Practice Address - City:LYNN
Practice Address - State:MA
Practice Address - Zip Code:01904-2319
Practice Address - Country:US
Practice Address - Phone:978-387-3392
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-05-21
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical