Healthcare Provider Details

I. General information

NPI: 1659473445
Provider Name (Legal Business Name): WINSOME PATRICIA MELLERS LCSW. CAC-CDAC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

950 CAMPBELL AVE
WEST HAVEN CT
06516-2770
US

IV. Provider business mailing address

151 MALCOLM RD
WEST HAVEN CT
06516-1243
US

V. Phone/Fax

Practice location:
  • Phone: 203-932-5711
  • Fax: 203-937-4711
Mailing address:
  • Phone: 203-932-5711
  • Fax: 203-937-4791

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number000571
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number1896
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number004861
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: