Doctor Name: | JAMES L MELLO |
NPI Number: | 1396079604 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LADC, CCS |
License Number: | CCS2848 |
Business Practice Address: | 28 Congress St Rumford, ME - 042762092 |
Business Phone Number: | 2073647006 |
Business Fax Number: | 2073647007 |
Mailing Address: | 28 Congress St, RUMFORD |
State: | ME |
Postal Code: | 042762092 |
Phone Number: | 2073647006 |
Fax Number: | 2073647007 |
NPI Enumeration Date: | 09/21/2009 |
NPI Last Update Date: | 09/21/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | CCS2848 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | ME |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |