Healthcare Provider Details

I. General information

NPI: 1609001882
Provider Name (Legal Business Name): MELISSA NOUEL M.S., C.S.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: MELISSA TORO

II. Dates (important events)

Enumeration Date: 05/18/2009
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 AVENUE AT PORT IMPERIAL APT 1025
WEEHAWKEN NJ
07086-6964
US

IV. Provider business mailing address

1300 AVENUE AT PORT IMPERIAL APT 1025
WEEHAWKEN NJ
07086-6964
US

V. Phone/Fax

Practice location:
  • Phone: 646-247-7108
  • Fax:
Mailing address:
  • Phone: 646-247-7108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TS0200X
TaxonomySchool Psychologist
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: