Healthcare Provider Details

I. General information

NPI: 1952221889
Provider Name (Legal Business Name): MELISSA CARSON MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LISA CARSON

II. Dates (important events)

Enumeration Date: 07/20/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

965 CHURCH ST
NEW BEDFORD MA
02745-1400
US

IV. Provider business mailing address

259B MIDDLEBORO RD
EAST FREETOWN MA
02717
US

V. Phone/Fax

Practice location:
  • Phone: 508-996-3154
  • Fax:
Mailing address:
  • Phone: 617-763-9603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: