Individual provider Active NPI

Melanie Hannon, LCSW, LADC

  • Clinical Social Worker
  • Portland, ME
National Provider Identifier
1063836732
Registry record updated Jan 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LC20073 Issued in ME
Practice address
216 Vaughan St
Portland, ME 04102-3204
Phone
(207) 662-2221
Fax
(207) 810-2367
NPI assigned
Feb 14, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 27, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X MA
Addiction (Substance Use Disorder) Counselor 101YA0400X LC8912 ME
Clinical Social Worker 1041C0700X LC20073 ME Primary

Addresses

Primary practice location

216 Vaughan St
Portland, ME 04102-3204

Mailing address

216 Vaughan St
Portland, ME 04102-3204
Phone (207) 662-2221

Other practice location 1

1153 Centre St
Boston, MA 02130-3446
Phone (617) 983-7702

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Nov 8, 2022 through Nov 8, 2026

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC8912MEMDAddiction (Substance Use Disorder) Counselor
LC20073MEMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Healing Therapy, LLC Clinical Current Accepting new patients

Locations

3 Allied Dr
Ste 303
Dedham, MA 02026
Phone (617) 645-4819

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1392336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737936000000",
    "number": "1063836732",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "216 VAUGHAN ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023204",
            "telephone_number": "207-662-2221",
            "fax_number": "207-810-2367"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "216 VAUGHAN ST",
            "city": "PORTLAND",
            "state": "ME",
            "postal_code": "041023204",
            "telephone_number": "207-662-2221",
            "fax_number": "207-810-2367"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1153 Centre St",
            "address_purpose": "LOCATION",
            "city": "Boston",
            "state": "MA",
            "postal_code": "021303446",
            "country_code": "US",
            "telephone_number": "617-983-7702",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HANNON",
        "first_name": "MELANIE",
        "credential": "LCSW, LADC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-14",
        "last_updated": "2025-01-27",
        "certification_date": "2025-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": null,
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "ME",
            "license": "LC8912",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "ME",
            "license": "LC20073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, ME

Sources for this page

Verify at the official NPI Registry.