Healthcare Provider Details

I. General information

NPI: 1689582199
Provider Name (Legal Business Name): MELISSA COUNTIE COUNSELING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 NEWBURY ST STE 203
DANVERS MA
01923-1065
US

IV. Provider business mailing address

435 NEWBURY ST STE 203
DANVERS MA
01923-1065
US

V. Phone/Fax

Practice location:
  • Phone: 617-539-2812
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MELISSA COUNTIE
Title or Position: LMHC
Credential: LMHC
Phone: 617-539-2812