Provider Demographics
NPI:1811018716
Name:MANCINI, MELINDA (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:
Last Name:MANCINI
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 EATON STREET
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-5744
Mailing Address - Country:US
Mailing Address - Phone:978-369-9938
Mailing Address - Fax:
Practice Address - Street 1:2557 MASSACHUSETTS AVE
Practice Address - Street 2:
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02140-1020
Practice Address - Country:US
Practice Address - Phone:978-369-9938
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4060101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health