Provider Demographics
NPI:1952021651
Name:MATHIEU, MELINDA M (LMSW-CC)
Entity Type:Individual
Prefix:MRS
First Name:MELINDA
Middle Name:M
Last Name:MATHIEU
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:MELINDA
Other - Middle Name:M
Other - Last Name:FARRINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1088 WATERVILLE RD
Mailing Address - Street 2:
Mailing Address - City:SKOWHEGAN
Mailing Address - State:ME
Mailing Address - Zip Code:04976-4913
Mailing Address - Country:US
Mailing Address - Phone:207-660-8808
Mailing Address - Fax:
Practice Address - Street 1:5 COMMERCE DR
Practice Address - Street 2:
Practice Address - City:SKOWHEGAN
Practice Address - State:ME
Practice Address - Zip Code:04976-4823
Practice Address - Country:US
Practice Address - Phone:207-474-8368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-01
Last Update Date:2022-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC213471041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical