Provider Demographics
NPI:1699547992
Name:BRAGA, MELISSA (LICSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:BRAGA
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 CHAMPA RD
Mailing Address - Street 2:
Mailing Address - City:BILLERICA
Mailing Address - State:MA
Mailing Address - Zip Code:01821-2914
Mailing Address - Country:US
Mailing Address - Phone:303-903-3864
Mailing Address - Fax:
Practice Address - Street 1:25 CHAMPA RD
Practice Address - Street 2:
Practice Address - City:BILLERICA
Practice Address - State:MA
Practice Address - Zip Code:01821-2914
Practice Address - Country:US
Practice Address - Phone:303-903-3864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-30
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1271451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical