Provider Demographics
NPI:1508920083
Name:MELL, JAMES WINSTON (LCADC)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:WINSTON
Last Name:MELL
Suffix:
Gender:M
Credentials:LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 MAIN ST
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SUCCASUNNA
Mailing Address - State:NJ
Mailing Address - Zip Code:07876-1400
Mailing Address - Country:US
Mailing Address - Phone:973-927-9555
Mailing Address - Fax:973-927-2250
Practice Address - Street 1:54 MAIN ST
Practice Address - Street 2:SUITE 201
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1400
Practice Address - Country:US
Practice Address - Phone:973-927-9555
Practice Address - Fax:973-927-2250
Is Sole Proprietor?:No
Enumeration Date:2006-12-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00037700101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)