Provider Demographics
NPI:1841376514
Name:PERROTTO, MELISSA ANNE
Entity type:Individual
Prefix:MS
First Name:MELISSA
Middle Name:ANNE
Last Name:PERROTTO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:ANNE
Other - Last Name:VAN WIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMHC
Mailing Address - Street 1:4 CHAMPION WAY
Mailing Address - Street 2:
Mailing Address - City:PEMBROKE
Mailing Address - State:MA
Mailing Address - Zip Code:02359-2637
Mailing Address - Country:US
Mailing Address - Phone:508-830-1630
Mailing Address - Fax:508-830-0768
Practice Address - Street 1:64 INDUSTRIAL PARK RD
Practice Address - Street 2:BAYVIEW ASSOCIATES/SOUTH SHORE MENTAL HEALTH
Practice Address - City:PLYMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02360-4881
Practice Address - Country:US
Practice Address - Phone:508-830-1630
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA5896101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health