MEDICARE: MELISSA LANZ MA

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
1	101YM0800X	Mental Health Counselor
2	101YM0800X	Mental Health Counselor	768	NH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	7706646Y0NH01	OTHER	NH	ANTHEM

General Provider Information

NPI Number	:	1447323464
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MELISSA LANZ MA

Provider Business Mailing Address
First Line	:	79 BEECH HILL RD
Second Line	:
City	:	CAMPTON
State	:	NH
Zip	:	03223-4300
Country	:	US
Telephone Number	:	603-726-0305
Fax Number	:

Provider Business Practice Location Address
First Line	:	6 CHENELL DR STE 100
Second Line	:
City	:	CONCORD
State	:	NH
Zip	:	03301-8514
Country	:	US
Telephone Number	:	603-545-8355
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2006
Last Update Date	:	01/04/2021

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Directions to “ MELISSA LANZ MA” Practice Location

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