Healthcare Provider Details

I. General information

NPI: 1649715327
Provider Name (Legal Business Name): CARMEN MELECIO-FELICIANO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARMEN MAYRA MELECIO-FELICIANO

II. Dates (important events)

Enumeration Date: 01/04/2017
Last Update Date: 07/28/2026
Certification Date: 07/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 CENTER ST
CHICOPEE MA
01013-2680
US

IV. Provider business mailing address

10 CENTER ST
CHICOPEE MA
01013-2680
US

V. Phone/Fax

Practice location:
  • Phone: 413-540-1234
  • Fax:
Mailing address:
  • Phone: 413-540-1234
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: