Provider Demographics
NPI:1811329246
Name:CABRERA, MELYNDA RAMONA (MS, NCC, LPC)
Entity type:Individual
Prefix:MS
First Name:MELYNDA
Middle Name:RAMONA
Last Name:CABRERA
Suffix:
Gender:F
Credentials:MS, NCC, LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 PETER RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHBURY
Mailing Address - State:CT
Mailing Address - Zip Code:06488-2631
Mailing Address - Country:US
Mailing Address - Phone:203-592-6655
Mailing Address - Fax:
Practice Address - Street 1:77 MAIN ST N
Practice Address - Street 2:
Practice Address - City:SOUTHBURY
Practice Address - State:CT
Practice Address - Zip Code:06488-2200
Practice Address - Country:US
Practice Address - Phone:203-518-5380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-08-08
Last Update Date:2023-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT2403101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional