Jesse R Mellor, LADC

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

114 Issued in MA

Practice address

44 Front St
490
Worcester, MA 01608-1733

Phone

(508) 799-2934

Fax

(508) 770-1732

NPI assigned

Nov 26, 2008

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• Henry Lee Willis Community Center, Inc

  • Clinic/Center
  • Worcester, MA
  • NPI 1649344821
  NPD (past)

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

{
    "created_epoch": "1227657600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1227657600000",
    "number": "1275788663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 FOREST ST",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016091529",
            "telephone_number": "508-799-2934",
            "fax_number": "508-770-1732"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "44 FRONT ST",
            "address_2": "490",
            "city": "WORCESTER",
            "state": "MA",
            "postal_code": "016081733",
            "telephone_number": "508-799-2934",
            "fax_number": "508-770-1732"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLOR",
        "first_name": "JESSE",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LADC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-11-26",
        "last_updated": "2008-11-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "MA",
            "license": "114",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Chelsea Marie Mellen
• Steven M Meller, MD
• Erika Mello Souza, D.O.
• Danielle Marie Mello
• Marissa Rose Mello
• Laura Melnick
• Veronika Melnik, MD
• Pavel Melnikov, MD
• Bruce Meltzer, M.D.
• Jeremy Blair Meltzer, MD

• Addiction (Substance Use Disorder) Counselor in Worcester, MA
• Providers in Worcester, MA by specialty
• Addiction (Substance Use Disorder) Counselor in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 2008; 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.