Melissa Dessereau LLC

Primary specialty

Marriage & Family TherapistTaxonomy code 106H00000X

License

MF000928 Issued in PA

Legal business name

MELISSA DESSEREAU LLC

Practice address

255 S 17TH St
Philadelphia, PA 19103-6231

Phone

(267) 222-0851

NPI assigned

Apr 12, 2017

Organization subpart

No

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

Authorized official

Name

Melissa Slaboda Dessereau, LMFT

Title

Psychotherapist

Phone

(267) 222-0851

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1491955200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491955200000",
    "number": "1801320262",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "434 LONGFELLOW RD",
            "city": "WYNCOTE",
            "state": "PA",
            "postal_code": "190951913",
            "telephone_number": "267-222-0851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "255 S 17TH ST",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191036231",
            "telephone_number": "267-222-0851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MELISSA DESSEREAU LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-12",
        "last_updated": "2017-04-12",
        "status": "A",
        "authorized_official_last_name": "DESSEREAU",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_middle_name": "SLABODA",
        "authorized_official_title_or_position": "PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "267-222-0851",
        "authorized_official_credential": "LMFT"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Marriage & Family Therapist",
            "state": "PA",
            "license": "MF000928",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Marriage & Family Therapist in Philadelphia, PA
• Providers in Philadelphia, PA by specialty
• Marriage & Family Therapist in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2017; 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.