Healthcare Provider Details

I. General information

NPI: 1558747386
Provider Name (Legal Business Name): MELISSA HOON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2015
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75 BERLIN RD STE 101
CROMWELL CT
06416-2633
US

IV. Provider business mailing address

75 BERLIN RD STE 101
CROMWELL CT
06416-2633
US

V. Phone/Fax

Practice location:
  • Phone: 860-559-5433
  • Fax:
Mailing address:
  • Phone: 860-559-5433
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004271
License Number StateCT

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: