Active NPI
Mary Jo Melloni, LICSW,MSW
- School Social Worker
- Tewksbury, MA
National Provider Identifier
1912487729
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- License
- 105312
- Practice address
- 139 Pleasant St
Tewksbury, MA 01876-2725 - Phone
- (978) 640-4080
- NPI assigned
- Aug 21, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | 105312 | MA | Primary |
Addresses
Primary practice location
139 Pleasant St
Tewksbury, MA 01876-2725
Mailing address
70 Maureen Dr
Tewksbury, MA 01876-3621
Phone (978) 851-5834
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105312 | MA | MD | School Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1534809600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1534809600000",
"number": "1912487729",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "70 MAUREEN DR",
"city": "TEWKSBURY",
"state": "MA",
"postal_code": "018763621",
"telephone_number": "978-851-5834"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "139 PLEASANT ST",
"city": "TEWKSBURY",
"state": "MA",
"postal_code": "018762725",
"telephone_number": "978-640-4080"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MELLONI",
"first_name": "MARY JO",
"credential": "LICSW,MSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-08-21",
"last_updated": "2018-08-21",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": "MA",
"license": "105312",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tewksbury, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.