MEDICARE: MELISSA NOVALIS LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	00257	NJ

General Provider Information

NPI Number	:	1154745065
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA NOVALIS LPC

Provider Business Mailing Address
First Line	:	150 SPRING VALLEY RD
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6418
Country	:	US
Telephone Number	:	973-966-8690
Fax Number	:

Provider Business Practice Location Address
First Line	:	150 SPRING VALLEY RD
Second Line	:
City	:	MORRISTOWN
State	:	NJ
Zip	:	07960-6418
Country	:	US
Telephone Number	:	973-966-8690
Fax Number	:	973-520-4228

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/12/2014
Last Update Date	:	02/12/2014

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