Provider Demographics
NPI:1811748510
Name:MELISSA WOJTKOWSKI LMHC LADC CORP
Entity type:Organization
Organization Name:MELISSA WOJTKOWSKI LMHC LADC CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRIVATE PRACTIONER
Authorized Official - Prefix:
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:
Authorized Official - Last Name:WOJTKOWSKI
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:774-239-4002
Mailing Address - Street 1:531 SUMMER ST STE 1
Mailing Address - Street 2:
Mailing Address - City:BARRE
Mailing Address - State:MA
Mailing Address - Zip Code:01005-9590
Mailing Address - Country:US
Mailing Address - Phone:774-239-4002
Mailing Address - Fax:
Practice Address - Street 1:531 SUMMER ST STE 1
Practice Address - Street 2:
Practice Address - City:BARRE
Practice Address - State:MA
Practice Address - Zip Code:01005-9590
Practice Address - Country:US
Practice Address - Phone:774-239-4002
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-03-29
Last Update Date:2024-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health