Individual provider Active NPI

Melanie R Dement, PSY.D.

  • Clinical Psychologist
  • North Andover, MA
National Provider Identifier
1497715981
Registry record updated Jul 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
8205 Issued in MA
Practice address
451 Andover St
Suite 301
North Andover, MA 01845-5044
Phone
(617) 947-0883
NPI assigned
Mar 27, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Psychologist 103TC0700X 8205 MA Primary

Addresses

Primary practice location

451 Andover St
Suite 301
North Andover, MA 01845-5044

Mailing address

11 Penacook Rd
Sandown, NH 03873-2149
Phone (617) 947-0883

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20111214000187 MA Practitioner - Clinical Psychologist 9133171721 Practice locations: Andover, MA

Care Compare profile

Medicare Care Compare
Specialty
Clinical Psychologist
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

204 Andover St
Suite 403
Andover, MA 01810-5702
Phone (617) 947-0883

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8205MAMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Child and Family Psychological Services, PLLC Clinical PastSince Sep 19, 2018 Accepting new patients
Lynn Community Health, Inc. PastSince Dec 26, 2014 Accepting new patients

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1143417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311292800000",
    "number": "1497715981",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11 PENACOOK RD",
            "city": "SANDOWN",
            "state": "NH",
            "postal_code": "038732149",
            "telephone_number": "617-947-0883"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "451 ANDOVER ST",
            "address_2": "SUITE 301",
            "city": "NORTH ANDOVER",
            "state": "MA",
            "postal_code": "018455044",
            "telephone_number": "617-947-0883"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DEMENT",
        "first_name": "MELANIE",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "PSY.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-27",
        "last_updated": "2011-07-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "8205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in North Andover, MA

Sources for this page

Verify at the official NPI Registry.