Healthcare Provider Details

I. General information

NPI: 1497237515
Provider Name (Legal Business Name): MELANIE MARIA MASDEA-DIGNUM MSW, ACHT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/05/2018
Last Update Date: 09/05/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

165 KEMBLE ST
LENOX MA
01240-2863
US

IV. Provider business mailing address

40 SUMMIT RD
RICHMOND MA
01254-5131
US

V. Phone/Fax

Practice location:
  • Phone: 413-637-4400
  • Fax:
Mailing address:
  • Phone: 413-822-8928
  • Fax: 413-698-2891

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number107802
License Number StateMA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: