Provider Demographics
NPI:1861632895
Name:MELE, RACHEL H (LICSW)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:H
Last Name:MELE
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:330 MOUNT AUBURN ST
Mailing Address - Street 2:CLARK 126
Mailing Address - City:CAMBRIDGE
Mailing Address - State:MA
Mailing Address - Zip Code:02138-5502
Mailing Address - Country:US
Mailing Address - Phone:617-499-5054
Mailing Address - Fax:617-499-5465
Practice Address - Street 1:330 MOUNT AUBURN ST
Practice Address - Street 2:CLARK 126
Practice Address - City:CAMBRIDGE
Practice Address - State:MA
Practice Address - Zip Code:02138-5502
Practice Address - Country:US
Practice Address - Phone:617-499-5054
Practice Address - Fax:617-499-5465
Is Sole Proprietor?:No
Enumeration Date:2009-03-04
Last Update Date:2010-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1020861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA001293401Medicare UPIN