Healthcare Provider Details

I. General information

NPI: 1356517783
Provider Name (Legal Business Name): JOHN THOMAS MELAHN LCSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2008
Last Update Date: 10/18/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

40 BALDWIN RD STE 5
PARSIPPANY NJ
07054-2986
US

IV. Provider business mailing address

15 KENTWOOD RD
SUCCASUNNA NJ
07876-1405
US

V. Phone/Fax

Practice location:
  • Phone: 973-316-6077
  • Fax: 973-541-1706
Mailing address:
  • Phone: 201-317-9457
  • Fax: 973-541-1706

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC04737200
License Number StateNJ

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: