Provider Demographics
NPI:1730389750
Name:NISHMAN, MELISSA MACNISH (MA)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:MACNISH
Last Name:NISHMAN
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:
Other - Last Name:MACNISH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHC
Mailing Address - Street 1:3464 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:JAMAICA PLAIN
Mailing Address - State:MA
Mailing Address - Zip Code:02130-2665
Mailing Address - Country:US
Mailing Address - Phone:857-719-4237
Mailing Address - Fax:
Practice Address - Street 1:3464 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:JAMAICA PLAIN
Practice Address - State:MA
Practice Address - Zip Code:02130-2665
Practice Address - Country:US
Practice Address - Phone:857-719-4237
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2011-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health