Individual provider Active NPI

Melanie Molloy

  • Professional Counselor
  • Fair Lawn, NJ
National Provider Identifier
1659003663
Registry record updated Jun 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
Practice address
22-08 Route 208 Ste 16
Fair Lawn, NJ 07410-2609
Phone
(201) 956-6363
NPI assigned
Jun 28, 2022
Last updated
Jun 28, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X Primary

Addresses

Primary practice location

22-08 Route 208 Ste 16
Fair Lawn, NJ 07410-2609

Mailing address

204 Hillside Ave Unit 3
Glen Ridge, NJ 07028-2344
Phone (978) 335-6561

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Wellsprings Counseling Center, LLC CurrentSince Jan 7, 2024 Accepting new patients

Locations

22-08 State Rt 208
Ste 16
Fair Lawn, NJ 07410
Phone (201) 956-6363

Organizations & group practices 1

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": "1656374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656374400000",
    "number": "1659003663",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "204 HILLSIDE AVE UNIT 3",
            "city": "GLEN RIDGE",
            "state": "NJ",
            "postal_code": "070282344",
            "telephone_number": "978-335-6561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22-08 ROUTE 208 STE 16",
            "city": "FAIR LAWN",
            "state": "NJ",
            "postal_code": "074102609",
            "telephone_number": "201-956-6363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MOLLOY",
        "first_name": "MELANIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-06-28",
        "last_updated": "2022-06-28",
        "certification_date": "2022-06-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fair Lawn, NJ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2022; 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.