Healthcare Provider Details

I. General information

NPI: 1154744886
Provider Name (Legal Business Name): GABRIELA MELLO MUNIZ LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GABRIELA DEMELLO

II. Dates (important events)

Enumeration Date: 01/31/2014
Last Update Date: 05/07/2026
Certification Date: 05/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

389 MAIN ST STE 301
MALDEN MA
02148-5017
US

IV. Provider business mailing address

389 MAIN ST STE 301
MALDEN MA
02148-5017
US

V. Phone/Fax

Practice location:
  • Phone: 617-804-2773
  • Fax:
Mailing address:
  • Phone: 781-420-9953
  • Fax: 617-221-5680

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number10412
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: