Healthcare Provider Details

I. General information

NPI: 1497434518
Provider Name (Legal Business Name): MELISSA POWELL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/17/2023
Last Update Date: 09/17/2025
Certification Date: 09/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

255 HIGHLAND AVE
NEEDHAM MA
02494-3023
US

IV. Provider business mailing address

255 HIGHLAND AVE
NEEDHAM MA
02494-3023
US

V. Phone/Fax

Practice location:
  • Phone: 781-449-1884
  • Fax:
Mailing address:
  • Phone: 781-449-1884
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number14498323
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: