Provider Demographics
NPI:1144540030
Name:STEPIEN, MELISSA C (RN/PC, PMHCNS-BC)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:C
Last Name:STEPIEN
Suffix:
Gender:F
Credentials:RN/PC, PMHCNS-BC
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:C
Other - Last Name:MELLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN/PC, PMHCNS-BC
Mailing Address - Street 1:105 MILLBURY ST
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MA
Mailing Address - Zip Code:01501-3205
Mailing Address - Country:US
Mailing Address - Phone:508-832-9691
Mailing Address - Fax:
Practice Address - Street 1:105 MILLBURY ST
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:MA
Practice Address - Zip Code:01501-3205
Practice Address - Country:US
Practice Address - Phone:508-832-9691
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-02
Last Update Date:2021-02-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
MARN260117364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health