Individual provider Active NPI

Marion Mello, LICSW

  • Clinical Social Worker
  • Haverhill, MA
National Provider Identifier
1942613617
Registry record updated Jun 10, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
118267 Issued in MA
Practice address
60 Merrimack St
Haverhill, MA 01830-6207
Phone
(978) 373-1126
NPI assigned
Jun 10, 2014
Last updated
Jun 10, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 118267 MA Primary

Addresses

Primary practice location

60 Merrimack St
Haverhill, MA 01830-6207

Mailing address

10 Lawton Dr
Newburyport, MA 01950-1853

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
I20140805002514 MA Practitioner - Clinical Social Worker 1052538675 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Northeast Behavioral Health Corporation CurrentSince Jun 2, 2014 Accepting new patients
Nova Initia Counseling, LLC Past Accepting new patients

Locations

199 Rosewood Dr
Ste 250
Danvers, MA 01923
Phone (978) 867-7756

60 Merrimack St
Haverhill, MA 01830
Phone (978) 373-1126

12 Methuen St
Ste 3
Lawrence, MA 01840
Phone (978) 683-3128

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": "1402358400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1402358400000",
    "number": "1942613617",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 LAWTON DR",
            "city": "NEWBURYPORT",
            "state": "MA",
            "postal_code": "019501853"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "60 MERRIMACK ST",
            "city": "HAVERHILL",
            "state": "MA",
            "postal_code": "018306207",
            "telephone_number": "978-373-1126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MELLO",
        "first_name": "MARION",
        "credential": "LICSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-10",
        "last_updated": "2014-06-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "118267",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Haverhill, MA

Sources for this page

Verify at the official NPI Registry.