Individual provider Active NPI

Melissa Jantz, LMHC

  • Mental Health Counselor
  • Providence, RI
National Provider Identifier
1356463590
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
5636 Issued in MA
Practice address
1 Richmond SQ Ste 103K
Providence, RI 02906-5166
Phone
(401) 728-1800
NPI assigned
Apr 6, 2007
Last updated
Jul 28, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 5636 MA Primary

Addresses

Primary practice location

1 Richmond SQ Ste 103K
Providence, RI 02906-5166

Mailing address

1162 Gar Hwy
Ste 4
Swansea, MA 02777-4224
Phone (508) 536-8088

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in RI, MA2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20240401002721 RI Practitioner - Mental Health Counselor 7810335569 Reassigns benefits to 1 organization
I20241223000895 MA Practitioner - Mental Health Counselor 7810335569 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
United Cerebral Palsy of Rhode Island, Inc. CurrentSince Feb 19, 2024 Accepting new patients
Reliant Medical Group, Inc CurrentSince Oct 12, 2024 Accepting new patients

Locations

225 New Lancaster Rd
Leominster, MA 01453
Phone (978) 466-3208

5 Neponset St
Worcester, MA 01606
Phone (508) 595-2300

5 Neponset St
Fl 12
Worcester, MA 01606
Phone (508) 852-6175

200 Main St
Ste 210
Pawtucket, RI 02860
Phone (401) 728-1800

1 Richmond Sq
Ste 103K
Providence, RI 02906
Phone (401) 288-1002

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1175817600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1356463590",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1162 GAR HWY",
            "address_2": "STE 4",
            "city": "SWANSEA",
            "state": "MA",
            "postal_code": "027774224",
            "telephone_number": "508-536-8088",
            "fax_number": "408-448-5617"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RICHMOND SQ STE 103K",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029065166",
            "telephone_number": "401-728-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JANTZ",
        "first_name": "MELISSA",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-06",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MA",
            "license": "5636",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, RI

Sources for this page

Verify at the official NPI Registry.