Healthcare Provider Details

I. General information

NPI: 1326115346
Provider Name (Legal Business Name): MELANIE CHENETTE LPC, LMHC, ATR-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 10/15/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 HIGH ST BROWN BLDG,, 2ND FLOOR, OFC. 6
WESTERLY RI
02891-1985
US

IV. Provider business mailing address

89 OAK RD
WAKEFIELD RI
02879-5515
US

V. Phone/Fax

Practice location:
  • Phone: 401-207-2212
  • Fax: 401-596-1826
Mailing address:
  • Phone: 860-455-6444
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMCH00513
License Number StateRI
# 2
Primary TaxonomyY
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number001889
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: