Provider Demographics
NPI:1538297098
Name:BRUNEAU, MELANIE BETH (LICSW)
Entity Type:Individual
Prefix:MRS
First Name:MELANIE
Middle Name:BETH
Last Name:BRUNEAU
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:MRS
Other - First Name:MELANIE
Other - Middle Name:BETH
Other - Last Name:MARCHAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LICSW
Mailing Address - Street 1:98 SCHOOL STREET
Mailing Address - Street 2:P.O. BOX 182
Mailing Address - City:NORTHBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:01534-1232
Mailing Address - Country:US
Mailing Address - Phone:508-234-8501
Mailing Address - Fax:
Practice Address - Street 1:206 MILFORD ST
Practice Address - Street 2:
Practice Address - City:UPTON
Practice Address - State:MA
Practice Address - Zip Code:01568-1309
Practice Address - Country:US
Practice Address - Phone:508-634-6420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1120881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical