Provider Demographics
NPI:1891853875
Name:AUDIER, MELISSA (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:
Last Name:AUDIER
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:275 HAVERHILL ST
Mailing Address - Street 2:
Mailing Address - City:NORTH READING
Mailing Address - State:MA
Mailing Address - Zip Code:01864-1452
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:352 PARK ST
Practice Address - Street 2:STE 208
Practice Address - City:NORTH READING
Practice Address - State:MA
Practice Address - Zip Code:01864-2158
Practice Address - Country:US
Practice Address - Phone:978-604-5802
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2021-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1031251104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAP08568OtherBLUE CROSS BLUE SHIELD
MAP08568OtherBLUE CROSS BLUE SHIELD