Provider Demographics
NPI:1396755112
Name:WINCHESTER, MELISSA MARIE (LCPC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MARIE
Last Name:WINCHESTER
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:MARIE
Other - Last Name:BERENDS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:188 WEEKS RD
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:ME
Mailing Address - Zip Code:04357-3306
Mailing Address - Country:US
Mailing Address - Phone:207-446-3650
Mailing Address - Fax:
Practice Address - Street 1:9 HILLCREST AVE
Practice Address - Street 2:
Practice Address - City:RANDOLPH
Practice Address - State:ME
Practice Address - Zip Code:04346-5131
Practice Address - Country:US
Practice Address - Phone:207-210-4382
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2025-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC1790101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME246510099Medicaid