Individual provider · Type 1 NPI
Jesse R. Mellor, LADC
Addiction (Substance Use Disorder) Counselor · Worcester, MA
NPI number
1275788663
Active
Practice location
44 Front St, 490
Worcester, MA 01608-1733
Fax (508) 770-1732
Mailing address
119 Forest St
Worcester, MA 01609-1529
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Addiction (Substance Use Disorder) Counselor Primary | 101YA0400X | 114 (MA) |
Addiction (Substance Use Disorder) Counselor: Definition to come...
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About NPI 1275788663
Jesse R. Mellor, LADC's National Provider Identifier is 1275788663, issued on Nov 26, 2008. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Worcester, MA. The record was last updated on Nov 26, 2008.