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General NPI Number Information
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NPI Number | 1881265023
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Entity Type | Individual
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Provider Name | MELANIE ANN PETERS LPC, ATR-BC
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Gender | Female
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Dates
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Enumeration Date | 07/08/2021
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Last Update Date | 07/08/2021
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Provider Practice Location Address
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Address Line | 11 OVERLOOK RD
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City | SUMMIT
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State | NJ
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Zip | 07901-3577
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Country | US
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Telephone | 908-522-5293
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Fax |
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Provider Business Mailing Address
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Address Line | 694 HONEYBROOK CIR
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City | STEWARTSVILLE
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State | NJ
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Zip | 08886-2913
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Country | US
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Telephone | 908-319-9684
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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 | 221700000X
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Taxonomy Name | Art Therapist
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License Number | 18-187
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License Number State | NJ
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 37PC00771700
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License Number State | NJ
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