Healthcare Provider Details

I. General information

NPI: 1396755112
Provider Name (Legal Business Name): MELISSA MARIE WINCHESTER LCPC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MELISSA MARIE BERENDS

II. Dates (important events)

Enumeration Date: 08/08/2006
Last Update Date: 02/27/2025
Certification Date: 02/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 HILLCREST AVE
RANDOLPH ME
04346-5131
US

IV. Provider business mailing address

188 WEEKS RD
RICHMOND ME
04357-3306
US

V. Phone/Fax

Practice location:
  • Phone: 207-210-4382
  • Fax:
Mailing address:
  • Phone: 207-446-3650
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCC1790
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: