MEDICARE: STACIE MELCHER 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
1	101YP2500X	Professional Counselor	000404	CT
2	101YP2500X	Professional Counselor	3695	MA

General Provider Information

NPI Number	:	1790918134
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STACIE MELCHER LMHC

Provider Business Mailing Address
First Line	:	19 CREST AVE
Second Line	:
City	:	LONGMEADOW
State	:	MA
Zip	:	01106-2321
Country	:	US
Telephone Number	:	413-567-0678
Fax Number	:

Provider Business Practice Location Address
First Line	:	19 CREST AVE
Second Line	:
City	:	LONGMEADOW
State	:	MA
Zip	:	01106-2321
Country	:	US
Telephone Number	:	860-543-4496
Fax Number	:

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

Provider Enumeration Date	:	09/02/2009
Last Update Date	:	02/12/2026

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