Healthcare Provider Details

I. General information

NPI: 1598162638
Provider Name (Legal Business Name): MELISSA ANNE HATHAWAY PHD, LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/03/2014
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 PATRIOT PL STE 200
FOXBOROUGH MA
02035-3304
US

IV. Provider business mailing address

26 PATRIOT PL STE 200
FOXBOROUGH MA
02035-3304
US

V. Phone/Fax

Practice location:
  • Phone: 508-838-0885
  • Fax:
Mailing address:
  • Phone: 508-838-0885
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMH20820
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberMHC01388
License Number StateRI
# 3
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number10479
License Number StateMA
# 4
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: