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General NPI Number Information
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NPI Number | 1669682480
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Entity Type | Individual
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Provider Name | MARCIA PAIGE MELANSON LICSW
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Gender | Female
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Dates
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Enumeration Date | 05/23/2007
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Last Update Date | 06/13/2013
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Provider Practice Location Address
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Address Line | 274 MAIN ST
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City | GROTON
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State | MA
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Zip | 01450-1236
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Country | US
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Telephone | 978-448-0009
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Fax | 866-311-1832
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Provider Business Mailing Address
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Address Line | PO BOX 316 274 MAIN STREET
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City | GROTON
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State | MA
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Zip | 01450-0316
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Country | US
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Telephone | 978-448-0009
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SW104961-1
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License Number State | MA
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