Healthcare Provider Details

I. General information

NPI: 1760617625
Provider Name (Legal Business Name): MELISSA M THAYER MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA M GRIFFIN

II. Dates (important events)

Enumeration Date: 05/21/2009
Last Update Date: 08/20/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

152 SYLVAN ST
DANVERS MA
01923-3558
US

IV. Provider business mailing address

152 SYLVAN ST
DANVERS MA
01923-3558
US

V. Phone/Fax

Practice location:
  • Phone: 978-774-6820
  • Fax: 978-777-4242
Mailing address:
  • Phone: 978-774-6820
  • Fax: 978-777-4242

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: