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General NPI Number Information
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NPI Number | 1821437658
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Entity Type | Individual
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Provider Name | MELISSA WEINER M.A., LPC
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Gender | Female
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Dates
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Enumeration Date | 06/14/2013
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Last Update Date | 06/14/2013
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Provider Practice Location Address
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Address Line | 2 OLD NEW MILFORD RD SUITE #2A
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City | BROOKFIELD
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State | CT
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Zip | 06804-2426
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Country | US
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Telephone | 203-775-3282
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Fax | 203-775-3478
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Provider Business Mailing Address
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Address Line | 10134 TOWN WALK DR
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City | HAMDEN
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State | CT
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Zip | 06518-3748
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Country | US
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Telephone | 917-676-0437
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 002374
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 005042-1
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License Number State | NY
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