Provider Demographics
NPI:1770206443
Name:MELONE, RYAN (LMHC, LPCC)
Entity type:Individual
Prefix:MR
First Name:RYAN
Middle Name:
Last Name:MELONE
Suffix:
Gender:M
Credentials:LMHC, LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:736 ARBORETUM WAY
Mailing Address - Street 2:
Mailing Address - City:BURLINGTON
Mailing Address - State:MA
Mailing Address - Zip Code:01803-3833
Mailing Address - Country:US
Mailing Address - Phone:224-305-9574
Mailing Address - Fax:
Practice Address - Street 1:736 ARBORETUM WAY
Practice Address - Street 2:
Practice Address - City:BURLINGTON
Practice Address - State:MA
Practice Address - Zip Code:01803-3833
Practice Address - Country:US
Practice Address - Phone:224-305-9574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-19
Last Update Date:2024-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALPCC13846101YP2500X
NY012270101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA941513140Medicaid