Healthcare Provider Details

I. General information

NPI: 1386918019
Provider Name (Legal Business Name): MELISSA AMARAL O'MEARA LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2012
Last Update Date: 08/27/2026
Certification Date: 08/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

294 CONCORD RD
BILLERICA MA
01821-3482
US

IV. Provider business mailing address

28 AVONDALE AVE
BILLERICA MA
01821-2406
US

V. Phone/Fax

Practice location:
  • Phone: 978-330-5105
  • Fax: 978-608-4102
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number114609
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: