Healthcare Provider Details

I. General information

NPI: 1568916831
Provider Name (Legal Business Name): JEANNE MELVIN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2016
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

267 ALLERTON COMMONS LN
BRAINTREE MA
02184
US

IV. Provider business mailing address

267 ALLERTON COMMONS LN
BRAINTREE MA
02184
US

V. Phone/Fax

Practice location:
  • Phone: 617-861-7382
  • Fax: 617-774-0336
Mailing address:
  • Phone: 617-861-7382
  • Fax: 617-774-0336

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number6008
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: