Provider Demographics
NPI:1952704132
Name:MCGRATH, MELISSA ERIN FITTA (LMSW-CC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ERIN FITTA
Last Name:MCGRATH
Suffix:
Gender:F
Credentials:LMSW-CC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:62 PEGASUS ST
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BRUNSWICK
Mailing Address - State:ME
Mailing Address - Zip Code:04011
Mailing Address - Country:US
Mailing Address - Phone:207-798-3922
Mailing Address - Fax:207-798-3944
Practice Address - Street 1:62 PEGASUS ST
Practice Address - Street 2:SUITE 300
Practice Address - City:BRUNSWICK
Practice Address - State:ME
Practice Address - Zip Code:04011
Practice Address - Country:US
Practice Address - Phone:207-798-3922
Practice Address - Fax:207-798-3944
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-02
Last Update Date:2014-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEMC14959104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker