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NPI Code Detail

MEDICARE: MISS MELISSA JUDITH GLASSMAN LMHC

MEDICARE: MISS MELISSA JUDITH GLASSMAN LMHC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101YM0800XMental Health Counselor5004MA

General Provider Information

NPI Number : 1376676502
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS MELISSA JUDITH GLASSMAN LMHC
Provider Business Mailing Address
First Line : 280 MERRIMACK ST
Second Line :
City : LAWRENCE
State : MA
Zip : 01843-1779
Country : US
Telephone Number : 978-738-4543
Fax Number :
Provider Business Practice Location Address
First Line : 3 BLACKBURN CTR
Second Line :
City : GLOUCESTER
State : MA
Zip : 01930-2268
Country : US
Telephone Number : 978-283-7198
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/14/2007
Last Update Date : 05/27/2022

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