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General NPI Number Information
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NPI Number | 1346122082
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Entity Type | Individual
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Provider Name | MELISSA ANAIS TEJADA I MSW
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Gender | Female
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Dates
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Enumeration Date | 07/23/2025
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Last Update Date | 07/23/2025
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Provider Practice Location Address
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Address Line | 66 CANAL ST
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City | BOSTON
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State | MA
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Zip | 02114-2002
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Country | US
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Telephone | 617-371-3175
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Fax | 617-371-3038
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Provider Business Mailing Address
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Address Line | 11 HERBERT ST
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City | EVERETT
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State | MA
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Zip | 02149-1413
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Country | US
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Telephone | 781-526-7823
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number |
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License Number State | MA
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