Provider Demographics
NPI:1518370386
Name:GARVEY, MELISSA ANN (CPS, LICSW)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANN
Last Name:GARVEY
Suffix:
Gender:F
Credentials:CPS, LICSW
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:A
Other - Last Name:NICHOLSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CPS, LI CS W
Mailing Address - Street 1:PO BOX 66
Mailing Address - Street 2:
Mailing Address - City:DURHAM
Mailing Address - State:NH
Mailing Address - Zip Code:03824-0066
Mailing Address - Country:US
Mailing Address - Phone:603-986-4638
Mailing Address - Fax:
Practice Address - Street 1:13 JENKINS CT
Practice Address - Street 2:
Practice Address - City:DURHAM
Practice Address - State:NH
Practice Address - Zip Code:03824-2340
Practice Address - Country:US
Practice Address - Phone:603-986-4638
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-09
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH1723101YA0400X, 101YM0800X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health