Provider Demographics
NPI:1922317924
Name:MELCHER, KRISTEN MARY (LMHC, CCPT)
Entity Type:Individual
Prefix:MRS
First Name:KRISTEN
Middle Name:MARY
Last Name:MELCHER
Suffix:
Gender:F
Credentials:LMHC, CCPT
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:MARY
Other - Last Name:FELLOWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:35 SUMMER ST
Mailing Address - Street 2:SUITE 202A
Mailing Address - City:TAUNTON
Mailing Address - State:MA
Mailing Address - Zip Code:02780-3469
Mailing Address - Country:US
Mailing Address - Phone:315-345-5623
Mailing Address - Fax:
Practice Address - Street 1:35 SUMMER ST
Practice Address - Street 2:SUITE 202A
Practice Address - City:TAUNTON
Practice Address - State:MA
Practice Address - Zip Code:02780-3469
Practice Address - Country:US
Practice Address - Phone:315-345-5623
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-26
Last Update Date:2014-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MA8659101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA# 8659OtherMENTAL HEALTH COUNSELOR LICENSE (LMHC)