Healthcare Provider Details

I. General information

NPI: 1457995409
Provider Name (Legal Business Name): RACHEL JEAN MELISI LCMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/02/2019
Last Update Date: 08/19/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

77 GILCREAST RD STE 3000
LONDONDERRY NH
03053-3563
US

IV. Provider business mailing address

10 TSIENNETO RD
DERRY NH
03038-1505
US

V. Phone/Fax

Practice location:
  • Phone: 603-883-0005
  • Fax:
Mailing address:
  • Phone: 603-434-1577
  • Fax: 603-965-0224

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number4665
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: