Provider Demographics
NPI:1518341999
Name:MELISSA DZEN, LMHC, LLC
Entity Type:Organization
Organization Name:MELISSA DZEN, LMHC, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LICENSED MENTAL HEALTH COUNSELOR
Authorized Official - Prefix:MRS
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:DZEN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:781-871-8777
Mailing Address - Street 1:136 OLD PELHAM ST
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-3706
Mailing Address - Country:US
Mailing Address - Phone:781-243-9880
Mailing Address - Fax:
Practice Address - Street 1:80 WASHINGTON ST STE C17
Practice Address - Street 2:
Practice Address - City:NORWELL
Practice Address - State:MA
Practice Address - Zip Code:02061-1729
Practice Address - Country:US
Practice Address - Phone:781-871-8777
Practice Address - Fax:781-261-9633
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-15
Last Update Date:2015-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA8318251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health