Healthcare Provider Details

I. General information

NPI: 1821796996
Provider Name (Legal Business Name): MELISHA USHER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/20/2023
Last Update Date: 02/20/2023
Certification Date: 02/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3013 DIXWELL AVE
HAMDEN CT
06518
US

IV. Provider business mailing address

3013 DIXWELL AVE
HAMDEN CT
06518
US

V. Phone/Fax

Practice location:
  • Phone: 203-400-1884
  • Fax: 203-651-1562
Mailing address:
  • Phone: 203-400-0188
  • Fax: 203-651-1562

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number2541
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: