Provider Demographics
NPI:1306728654
Name:SALEM COLLABORATIVE THERAPIST COLLECTIVE
Entity type:Organization
Organization Name:SALEM COLLABORATIVE THERAPIST COLLECTIVE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CO-OWNER
Authorized Official - Prefix:
Authorized Official - First Name:EMILIE
Authorized Official - Middle Name:
Authorized Official - Last Name:MELLAL
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:508-319-9771
Mailing Address - Street 1:81 WASHINGTON ST STE 302
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:MA
Mailing Address - Zip Code:01970-3514
Mailing Address - Country:US
Mailing Address - Phone:508-319-9771
Mailing Address - Fax:
Practice Address - Street 1:81 WASHINGTON ST STE 302
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:MA
Practice Address - Zip Code:01970-3514
Practice Address - Country:US
Practice Address - Phone:508-319-9771
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-25
Last Update Date:2025-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty