Active NPI
Anthony Mark Melillo, MSW,LICSW
- Clinical Social Worker
- Bennington, VT
National Provider Identifier
1225167984
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 089-0001010
- Practice address
- 504 Main St
Bennington, VT 05201-2111 - Phone
- (413) 446-4210
- NPI assigned
- Mar 5, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 089-0001010 | VT | Primary |
| Clinical Social Worker | 1041C0700X | 1024625 | MA | |
| Clinical Social Worker | 1041C0700X | 04-PE-AOOOAJ9 | WI |
Addresses
Primary practice location
504 Main St
Bennington, VT 05201-2111
Mailing address
23 Bradley Street
Anthony M Melillo
North Adams, MA 01247
Phone (413) 446-4210
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1011283 | Medicaid | VT | |
| CBH1057539 | Other | VT | CIGNA BEHAVIORAL HEALTH |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 04-PE-AOOOAJ9 | WI | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173052800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1225167984",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23 BRADLEY STREET",
"address_2": "ANTHONY M MELILLO",
"city": "NORTH ADAMS",
"state": "MA",
"postal_code": "01247",
"telephone_number": "413-446-4210"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "504 MAIN ST",
"city": "BENNINGTON",
"state": "VT",
"postal_code": "052012111",
"telephone_number": "413-446-4210"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELILLO",
"first_name": "ANTHONY",
"middle_name": "MARK",
"name_prefix": "Mr.",
"credential": "MSW,LICSW",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-05",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "VT",
"license": "089-0001010",
"primary": true
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MA",
"license": "1024625",
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "WI",
"license": "04-PE-AOOOAJ9",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1011283",
"state": "VT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA BEHAVIORAL HEALTH",
"identifier": "CBH1057539",
"state": "VT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Bennington, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.