Individual provider Active NPI

Daniel D Melle, MSW, LICSW

  • Clinical Social Worker
  • Worcester, MA
National Provider Identifier
1205065166
Registry record updated Jul 13, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
105679 Issued in MA
Practice address
275 Belmont St
Worcester, MA 01604-1675
Phone
(508) 860-1117
NPI assigned
Jul 13, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 13, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 105679 MA Primary

Addresses

Primary practice location

275 Belmont St
Worcester, MA 01604-1675

Mailing address

123 Everett Rd
Barre, MA 01005-8944
Phone (978) 355-6186

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
105679MAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1247443200000",
    "number": "1205065166",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 EVERETT RD",
            "city": "BARRE",
            "state": "MA",
            "postal_code": "010058944",
            "telephone_number": "978-355-6186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "275 BELMONT ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016041675",
            "telephone_number": "508-860-1117"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLE",
        "first_name": "DANIEL",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "MSW, LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-07-13",
        "last_updated": "2009-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "105679",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Worcester, MA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.